AHFE Open AccessAdvances in Human Aspects of Healthcare
Editors: Vincent Duffy, Nancy Lightner
Topics: Healthcare and Medical Devices
Publication Date: 2021
ISBN: 978-1-4951-2093-0
DOI: 10.54941/ahfe100470
Articles
Standards and Cross-Organization of Work: Two Useful Tools for A Prevention of Manual Handling of Patients in the Healthcare Sector
Preventive responses most often made to caregivers are too often "gestures and postures training" type to reduce these occupational hazards. Taking the party to focus on manual handling of patients (MMP), it seemed appropriate to revisit prevention measures being implemented by combining the results of international standardization and reflections on the organization of work. The approach described above has found its place in the training actions in applied ergonomics and prevention of risks related to physical activity for caregivers and their management. The objective is to convey to employees, tools for evaluation of work situations, adapted to their activity for taking into account the ergonomics for reducing the risk occurrence of MSDs. Such an approach fit into the development of working group and the cross disciplinary organizations.
Jean -Pierre Zana
Open Access
Article
Conference Proceedings
Design for Health and Dignity: User and Stakeholder Involvement in Design for Urinary Continence
Fully understanding stakeholder needs is important. For each project the participants, methods and timing of involvement should be considered (Vink et al 2008). Methods of engaging stakeholders and users are numerous, but case study examples demonstrating consultation in practice for incontinence product development are not frequently reported. The authors have been involved in a number of user-centred design projects that have been undertaken to enhance the health and dignity of patients and users in the UK. These projects have involved different levels of stakeholder and user involvement in the product development and evaluation process. This paper will describe two case studies focussed on product design for urinary continence management. This is an area in which stakeholder and user engagement is important but can be challenging to achieve. The way in which stakeholders were involved and the resulting impact is described.
Louise Moody, Adele Long, Avril McCarthy
Open Access
Article
Conference Proceedings
Assessment of Risk Factors of Low Back Pain Among Hospital Nurses
Nursing is an occupation with high prevalence of low back pain (LBP). This pain is multifactorial and assessing its risk factors is essential. The study aim was to determine the prevalence and risk factors of LBP among 225 hospital nurses in Thailand in a cross-sectional study. A self-reported questionnaire divided into six parts including personal factors, working factors, job stress modified from the Nursing Stress Scale, low back pain modified from the Standardized Nordic Questionnaire, health behaviors, and work environment was used for collecting the data. Data were analyzed by descriptive statistics and logistic regression. Study results revealed that the prevalence of LBP in the past seven days was 34.2%. Logistic regression analysis indicated that lifting overweight patients without assistance (OR=1.8; 95%CI=0.95-3.77) and having previous diseases related to LBP (OR=6.3; 95%CI=1.65-24.32) were important risk factors of LBP. Study findings are useful for developing LBP preventive strategies including training on lifting and transferring overweight patients by using a lift team method and lifting devices, developing a manual or guidelines for safe patient handling, and treatment of LBP.
Chuliporn Sopajareeya
Open Access
Article
Conference Proceedings
Prevention of Pressure Ulcers: Exploring the Influence of Nurses, Equipment and Working Techniques
Patient immobility remains to be one of the primary causes of pressure ulcers. In spite of the evidence supporting this, it still is a daily challenge to increase or at least stabilize patient mobility. In the process of activating and mobilizing patients the type of equipment and the working technique of nurses is crucial for success. At the same time these aspects are also crucial for the protection of nurses’ backs. Repositioning in bed is rated as one of the most physically demanding transfers for nurses. From an occupational health perspective these techniques have been designed in order to protect nurses backs, shoulders and arms. The bed itself, the type of mattress, but also transfer aids like lifters and sliding sheets influence the risk profile for both the patient (pressure ulcers and others) and the nurses (occupational health problems). Force- and pressure-measurements indicate that, in order to get the maximum primary or secondary preventive effect out of the equipment, the working technique of nurses plays an important part. An analysis was made of the three most common repositioning techniques. Measurements (MecMesin and X-Sensor) and calculations (3D SSPP 6.0) demonstrate that small differences in technique result in large differences in pressure distribution, contact-area, the risk of shear forces under the patient’s skin and the biomechanical load for the nurses. The conclusions drawn from these findings are partly contradictory when it comes to practical recommendations for the nurses. Even during the process of frequent repositioning, a procedure intended to reduce the risk of developing pressure ulcers, some of techniques currently taught in regular nursing training may be safe for the nurses to perform from an occupational health perspective, but in fact also result in an increase in risk for the patient instead of the intended decrease. In this study a cross-over is made between the field of biomechanics and ergonomics and the clinical research on the prevention and treatment of pressure ulcers. Such a cross-over, so far, although still in a developmental stage, seems to be relevant for daily practice and has led to a currently on-going process of re-design of transfer techniques.
Hanneke JJ Knibbea, Nico E. Knibbea, A. Klaassenb
Open Access
Article
Conference Proceedings
Pressure Ulcer Prevention: Keep it Safe, Keep it Simple!
Pressure Ulcer (PU) Prevention Guidelines typically recommend that vulnerable patients be physically repositioned every 2-4 hours, although the risk of caregiver injury is rarely discussed. Some guidelines, concerned with the fabric and construction of slings, continue to mandate the removal of lift equipment from beneath the patient after use and, despite a weak evidence base, this might lessen repositioning frequency and discourage safe practice. A pragmatic solution may be a flexible, breathable, quick-drying, low-friction lift sheet, designed to work in synergy with a pressure-redistributing mattress and which replaces the standard sheet. A series of standardised laboratory tests compared key performance characteristics of two sheet textiles: a 100% cotton hospital bed sheet and the Maxi Transfer™ sheet, a novel synthetic lift sheet. Results showed that when compared to the cotton sheet, the synthetic sheet was more breathable, had lower heat retention properties, superior wicking and better synergy with the therapeutic mattress. Regular repositioning, the cornerstone of PU prevention, is most likely to occur when clinicians have immediate access to lifting equipment. Replacing the standard bed sheet with an advanced textile, lifting device, may positively impact concordance with repositioning protocols, improve tissue microclimate and so improve patient outcomes and, importantly, caregiver safety.
Lyn Phillips
Open Access
Article
Conference Proceedings
An Ergonomics Study of Patient Flow and Waiting Room Layout Design for an Emergency Medicine Department
The objective of the investigation was to perform an ergonomics study of the patient flow and waiting room design facilities at the QEII Emergency Medicine Department with a view to minimize congestion and improve patient care and satisfaction. The patient flow study revealed that the average waiting times (min) for triage categories 1 to 5 varies considerably (1 to 140 minutes) from the recommended waiting times (immediate to 120 minutes). The patient arrival rate varied by day of the week and ranged from a low of 133 on Thursdays to a high of 154 on Mondays. The congestion at the waiting room resulted from: (1) an inadequate number of seating space, (2) an inappropriate location of public washrooms and (3) a lack of designated waiting areas for people to be seen at triage. The number of seating space in the waiting rooms can be increased by: (1) relocating one of the family rooms, (2) rearranging the chairs in the main and sub-waiting rooms and (3) providing additions for wheelchair accessible seating locations. Improved layout for waiting rooms was provided. To further alleviate the congestion in the waiting rooms alternate location/facilities should be considered.
Bijon Das a, Biman Das b
Open Access
Article
Conference Proceedings
Work Ability and Psychosocial Factors in Healthcare Settings: Results from a National Study
Interactions between the ageing process, heath status, lifestyle and work strongly influence the work ability. In this paper, the healthcare workers were the selected professional group and their Work Ability was analysed in order to develop Portuguese reference values and to determine the influence of socio-demographic and psychosocial factors in the WAI. The methodology encompassed the work ability analysis using the Portuguese Version of the Work Ability Index and the characterization of the psychosocial factors using the Portuguese Version of Copenhagen Psychosocial Questionnaire. The sample included 1016 individuals from Portuguese hospitals with different professional categories. In average our sample had good work ability. WAI did not correlate with age. Among those with better WAI, physicians and nursing aides were the seniors, pointing to a probable healthy worker effect. The COPSOQ showed critical values in the scales’ cognitive and emotional demands. The scales quantitative demands, role conflicts, sleep troubles, burnout, stress, depressive symptoms and offensive behaviors correlated negatively with WAI meaning that when these risk factors are lower the work ability is better. The scales role clarity, recognition, social community at work, quality of leadership, justice, self-efficacy, meaning of work, job satisfaction and development opportunities correlated positively with WAI probably acting as work ability protecting factors.
Teresa Cotrim, Carlos Fernandes da Silva, Vânia Amaral, Pedro Bem-Haja, Anabela Pereira
Open Access
Article
Conference Proceedings
Integrated Patient Risk Assessment: Moving & Handling, Falls, Pressure Ulcers, Continence, Dementia
This paper reports the development stages of an integrated patient risk assessment summary. The aim was to simplify the recording of assessment data and support communication of bedside information within the multi-disciplinary team. It is part of a larger study using human factors/ergonomics to manage the risk and associated injuries of in-patient falls. The previous documentation required staff to complete the appropriate sections of a 20 page adult admission risk assessment which was both complex and included duplication; thematic analysis identified that mobility and range of movement were recorded 17 times. Two workshops were held with subject matter experts (mobility, tissue viability, medication, falls) and medical ward staff. An iterative review process was used to identify, augment, reject and categorize themes and finally prioritize 7 topics for medical condition, confusion, mobility, fall history, skin condition, assistance needed to swallow/eat/drink and continence. There was also an alert box with information on allergies, infection control and communication (hearing and vision).
Sue Hignett, Elaine Goodwin, Laurie Wolf
Open Access
Article
Conference Proceedings
Cen / ISO Technical Report (TR) 12296 - 2013 Ergonomics, Manual Handling of People in the Healthcare Sector International Consensus
In 2012 a new ISO Technical Report (TR) 12296) was published, this TR was endorsed by CEN in July 2013. A working group of specialists have been working on this document for a period of more then 3 years. The working group was formed under the responsibility of Technical Committee ISO/TC 159, Ergonomics, Subcommittee SC3, Anthropometry and Biomechanics, representing 23 participating and 12 observing countries. Previous ISO standards and TR’s have had too little attention for the specific problems of patient handling in health care. ISO 11228 parts 1-2-3 address ergonomics and manual handling in general. ISO 11228 part 1 considers in an Annex in short the aspects of manual handling of living persons. The new TR is therefore intended to be a tool for assisting with the application of this series in the context of the healthcare sector. Its main goals are to improve caregivers' working conditions by decreasing biomechanical overload risk, thus limiting work-related illness and injury, as well as the consequent costs and absenteeism, and to account for patients' care quality, safety, dignity and privacy as regards their needs, including specific personal care and hygiene. The work was mainly done in a close cooperation with a scientific group called EPPHE (European Panel on Patient Handling Ergonomics). Members of this group have been working on the TR and have also been available to support ideas, provide materials and additional resources to assist in the development of the TR. EPPHE was formed in 2004 from a collaboration of Experts from the IEA Technical Committees on Healthcare Ergonomics and Musculoskeletal Disorders. (Hignett 2014). The final consensus document includes 6 Annexes with additional information and tools regarding:Risk Assessment and Risk EvaluationOrganizational aspects of patient handling interventionsAids and EquipmentBuildings and EnvironmentStaff education and trainingThe evaluation of intervention effectiveness
Elly M. Waaijer
Open Access
Article
Conference Proceedings
Did the Finnish Ergonomic Patient Handling Passport® evoke changes in vocational education and work places?
The Finnish Ergonomic Patient Handling Passport® (EPHP®) was developed in consensus with Finnish experts, and has been standardized and registered in Finland since 2009. The EPHP® scheme defines the competencies, skill, and knowledge levels needed to perform patient transfers safely; ensures compliance with legislative requirements; and enhances patient safety and the quality of care. In Finland to date, over 2 800 people have passed the EPHP® exam and 275 have undergone the instructor training, of whom one third are teachers from different levels of vocational education. The result of a small questionnaire to 80 instructors reveals that about half of the schools have an instructor training the EPHP® scheme in some form or other. In the practical nurses’ education, EPHP® training is most commonly optional (n =12) or supplementary (n=14), and in three collages compulsory. For the registered nurses and physiotherapists, EPHP® training is available in two organizations as compulsory, in two as optional, and in four as supplementary. In the workplaces, the progress has been faster and the benefits of EPHP® training in both the quality of care and well-being of staff are evident. The EPHP® training appears to achieve the aims set forth by work places.
Leena Tamminen-Peter a, Virpi Fagerström b
Open Access
Article
Conference Proceedings
Response to the Emergency in Hospital Facilities
Typically, organizations have some difficulty in implementing emergency response procedures, as these require the appropriate preparation, namely training and evacuation drills. In this context, it is important to plan properly all possible responses to emergency situations, to ensure that there is no need to act reactively. However, there is also necessity of training to specific procedures, diverse and achievable, with the aim of enable the effective and efficient response to situations that require a reactive response, i.e. after the emergency situation becomes real.The case in study concerns to hospital facilities with several services (surgery, psychiatry, among others), surgery rooms, medical appointments, intermediate and intensive care day hospital and hospital admissions. The whole structure is made with horizontal and vertical partitioning against fire.It is very important to perform periodic drills to ensure that the procedures are assimilated and very well known, making their future actions natural. The evacuation drills legally required will then test the quality of the response and demonstrate if the practice was enough and if the objectives were achieved. As more hospital personnel receive training, the simulacrum response will be better and consequently the reaction on emergency situations will improve too.
Miguel Corticeiro Neves, Paulo Gaspar
Open Access
Article
Conference Proceedings
Human Factors View of the Assistant at Laparoscopic Procedures – A Pilot Study
This study is part of a research project with the aim of reducing physical demand and workload of surgery staff. In a first step, human factors of assistant additional to the surgeon should be analyzed. Therefore subjective and objective measurement approach was utilized. In general the subjective results show slight perceived demand. Furthermore, the assistant in urology perceived less demand than in gynecology. The objective results show slight demand for the assistant in gynecology. Life-record-data revealed similar static body, head and arm postures for the assistant and the surgeon in gynecology. Furthermore, this study shows the observation that human factors are influenced by the common working space and the significance of the common task as a team. The workflow-chart shows many parallels in the movements of the upper arm of the surgeon and the assistant during the preparation phase. In conclusion, one similar technical supporting system might be developed for the surgeon and the assistant because of many parallels in ergonomics with the aim of reducing physical demand and workload.
Kristian Karlovic, Stefan Pfeffer, Thomas Maier, Karl-Dietrich Sievert
Open Access
Article
Conference Proceedings
Analysis of User-Induced Risks in the Neurosurgical OR
In the last decades, the number of user interfaces in the OR has considerably increased. Additionally, time pressure forces the surgeons to perform tasks in parallel. The major objective of our work, in the framework of the OR.NET project, was therefore to analyze the present situation in the neurosurgical OR in order to identify potential use-oriented risks and additionally provide proposals for appropriate countermeasures. We analyzed the workflow of 25 neurosurgical procedures with the workflow analysis tool mAIXflow and developed questionnaires for surgeons and nurses. We found that the usage of the navigation system, the CUSA ultrasonic aspirator, and the PACS-PC induced potential risks. Furthermore, various disruptive factors have been identified, such as phone calls during the intervention, longer absence of the unsterile nurse or shifted foot switches. The aforementioned problems may lead to risks, such as erroneous treatment of the patient, a prolongation of anesthesia, or use errors, due to an inappropriate cognitive workload of the surgeon. For risk reduction in case of use deficiencies, we propose the use of a sterile integrated user interface in a networked OR. To enhance communication, team-trainings could be helpful, and the setup of a mailbox could reduce the number of intraoperative phone calls.
Jasmin Dell’Annaa, Armin Janssa, Melanie Blaarb
Open Access
Article
Conference Proceedings
The Challenge of Early Mobilization on the Intensive Care Unit: The Ergonomic Opportunities and Barriers
In recent years ICU-care and ICU-management of the critically ill patient is paying more attention to long term effects of the stay on the ICU and of the negative consequences of immobilization, long periods of bed rest, mechanical ventilation and medication aimed at pain reduction and sedation. Immobilization in bed affects practically all body conditions within a very short time frame: ranging from less than an hour to a few days. Some of these effects are reversible, some are not and may result in negative long term effects of the stay on the ICU. Recently new devices and equipment have been developed that enable mobilization of ICU patients at an extremely early stage, even without the patient being aware of being mobilized and being ventilated. This so-called Early Mobilisation (EM) has shown to be safe, feasible and improves outcomes both in the short term and especially also in the long run. There is a gradually building body of knowledge demonstrating the positive effects. In spite of these positive developments mobilizing critically ill and very passive patients in the complicated and often crowded ICU environment is also a first degree ergonomic challenge. Currently occupational musculoskeletal disorders are already prevalent in an ICU environment among nurses and physical therapists across the world. Lifting, assisting and supporting these complicated patients often attached to monitoring and (live) supportive equipment 24 hours a day can be very strenuous. EM requires considerable additional effort from these workers. These ergonomic implications will need to be resolved if an EM policy is to be successfully implemented. Therefore a study was undertaken describing the current situation and the potential of EM for the ICU’s in Dutch hospitals. The results indicate a whole array of different descriptions of EM and a lack of consensus, the lack of sufficient and adequate equipment especially when it comes to ergonomic considerations for the nurses, a lack of knowledge of what is required for EM and a lack of up-to-date protocols indicating safe procedures for both patient and nurse. Nevertheless most nurses are convinced of the need for and relevance of EM and see opportunities there. However: they are mostly focused on the patient side of EM and have not sufficiently analyzed the potential consequences for their own health.
Hanneke JJ Knibbe a, Nico E. Knibbea, Elly Waaijerb
Open Access
Article
Conference Proceedings
Using Game-Play Metrics to Analyze User Experience of Playing Health-Promoted Somatosensory Video Game
Player experience evaluation is important for understanding game design and deployment problems. Unlike subjective approach which is built upon data expressed by the player, gameplay metrics based approach is based on objective and detailed data collected during gameplay. For Kinect-based somatosensory video games (SVG), gameplay metrics contains the objective gameplay experiences as well as the gameplay performance. Method: This paper analyzes the gameplay metrics collected from two Kinect-based SVG to study their gameplay experiences. The first game is designed for sit-to-stand training. Fifteen chronic rehabilitation patients played the game for two months. Their objective experience is measured using the head movement data collected from the Kinect sensor. Their game performance is the time to complete the game. The second game is designed for upper-limb exercise. Eight elderly played the game 2 times per week for 6 weeks. Their objective experience is measured using the hand movement speed derived from Kinect sensor. The gameplay performance is the gaming scores. Result & Discussion: The objective experiences have moderately strong correlation with the player’s motor ability; whereas the game performance is not related to motor ability. One of the reasons is that the SVG performance is affected not only by the player’s motor ability but also by their psychological status. Conclusion: The objective gameplay experiences of a properly designed Kinect SVG can be used for motor ability evaluation; whereas the gameplay performance can be used for more comprehensive assessment that considers both the motor ability and the psychological motivations.
Tien-Lung Sun, Ta-Min Hung, Chien-Hua Huang, Chung-Liang Lai, Chun Pei
Open Access
Article
Conference Proceedings
A Study of Medical Garment Design for Puerpera Based on Ergonomic Theory
Clean and comfortable medical garment for puerpera could make them feel relax and cheerful. This study aims to identify puerpera’s needs and their concerns, in order to design the puerperal medical garment in the light of ergonomic theory. A questionnaire was prepared and given to these people, which have investigated 125 puerperas aging from 20 to 40 who are in treatment in central city hospital, as the data shows that most of the participants need functional garment, which should be in compliance with design rationales according to analysis data and in conformity with ergonomic theory. It was established that the functional medical garment for puerpera in conformity with ergonomic theory could not only promote puerpera’s entire recovery, prevent cross infection by pathogenic bacteria, but also benefit the breastfeeding and contact between mother and baby in the early stage, and make puerpera more cheerful.
Zhaojing Lan, Xiaoping Hu*
Open Access
Article
Conference Proceedings
Organizational Aspects Influencing Adherence to Worksite Exercises at Hospitals
Nursing workers are exposed to several risk factors which contribute to musculoskeletal disorders (WRMD). Workplace exercise is among the measures for controlling WRMD. However, work organization aspects can affect the adherence to exercise programs. Thus, the objective of this study was to identify organizational aspects related to workers´ exercise adherence in different hospital sectors. Methods: 135 nursing aides from 3 hospital sectors were invited to take part in the study. Personal, occupational aspects and sick leave information were analyzed together with responses to the Job Content Questionnaire (JCQ). An exercise program was offered over 3 months. Data were analyzed by chi-square tests. Results: Only 1/3 of the workers took part in the exercise program. Most of them (64%/N=24) were from Intensive Care Units. There was no association between exercise adherence and organizational aspects evaluated by the JCQ. There was a difference between exercise adherence and the work sector (p≤0.0001). Conclusions: Other aspects of work organization not evaluated by the JCQ can influence exercise adherence and should be investigated in future studies. In addition, intervention aiming to improve work conditions needs be conducted in a broader context, in which Ergonomics plays a major role.
Fabiana Almeida Foltran, Roberta de Fátima Carreira Moreira, Helenice Jane Cote Gil Coury
Open Access
Article
Conference Proceedings
Changes in Electroencephalography Signals During Massage
This study aimed to analyze the effect of massage on mental mechanisms by using electroencephalography (EEG) before, during, and after massage. The patient was placed in a supine position and received a massage from both an expert physical therapist, with 20 years experiences, and a person with no experience in therapeutic massage. EEG was recorded before, during, and after the massage. The portion of the body given the massage was only the left-side plantar arch, and the massage method was finger pressure applied by the thumb. The massage given by the expert evident alpha waves after massage. In contrast, the massage given by the inexperienced person did not induce any alpha changes. In this study, a massage from an inexperienced person did not change alpha activity before, during, or after the massage. Accordingly, the appearance of an alpha wave after massage is thought to correspond to the level of arousal of the patient gradually decreasing after massage—an indication that the patient had had a comfortable experience. In this study, it is suggested that a massage given by an expert physical therapist promotes emotional stability.
Hisanori Yuminaga*, Katsuma Yamada**, Masaru Ogiri***
Open Access
Article
Conference Proceedings
Ergonomics Intervention Among Football Players
We summarize recent studies to shed some light on the benefit of ergonomic approaches in sports and more specifically in football. In football, the physical demands can lead to muscular pain. Pressure pain mapping can be used as a surrogate for evaluation of the sensory changes in sports. Thus, pressure pain threshold (PPTs) was assessed in a set of studies 1) to compare topographical pressure pain sensitivity maps of the lower extremity in elite footballers playing on artificial turf or natural grass; 2) to investigate specialized recovery training on lower extremities pressure pain sensitivity; 3) to measure the effect of the usage of shock-absorbing insoles on foot PPTs during training among young soccer players on artificial turf. In total of 102 football players participated in these studies. Pressure pain thresholds were measured bilaterally over 23 locations of the lower extremity, including the rectus femoris, tensor fasciae latae, vastus lateralis/medialis; external and internal hamstrings; tibialis anterior; peroneous; external and internal gastrocnemius, and soleus muscles, in a blinded design. Further, PPTs measured at the 1-3-5 metatarsal bones; abductor digiti minimi muscle; flexor digitorum brevis muscle; abductor hallucis muscle, and calcaneus bone. Pain intensity and comfort were assessed using numeric rating scales. Our studies showed that football players playing on natural grass exhibited lower PPTs as compared to those players playing on artificial turf, specialized recovery training results in a decrease of muscles sensitivity 48 hours after game and addition of shock-absorbing insoles resulted in a significantly increased PPTs and reduced pain intensity as compared with playing without insoles.
Adam Kawczyński a, Pascal Madeleine b, Afshin Samani b
Open Access
Article
Conference Proceedings
Formative Intervention to Change the School Health Center Activity
The aim of this paper is to propose an interventionist approach for transforming a School Health Center (CSE) in São Paulo, Brazil. The Center is in a situation of crisis, providing precarious health services due to limited human and material resources. In the article we argue that the solution for the crisis depends on how it is interpreted. We present an ethnographic narrative constructed collectively by researcher and practitioners through data from interviews and a mini-intervention. The aim of this narrative was to provide a better understanding about the development of the activity of health care and education/research conducted at the CSE. As it will be argued this hypothesis is the first step towards a broader on-going intervention using a method called Change Laboratory, which is based on an Activity Theoretical approach. The narrative shows that the School Health Center’s object (primary and secondary health care) and the object of the Faculty of Public Health (research and education) have changed towards different developmental directions. The integration between these two objects is narrower than when the Center was first created, and this can be a key source of conflicts between CSE by the Faculty. The results suggest that a more effective solution to the crisis would involve the reconstruction of the object motivation (product service) produced in the activity.
Susana Vi Costa a, Rodolfo AG Vilela a, Marco Antonio Pereira Querolb
Open Access
Article
Conference Proceedings
Ergonomic Analysis Regarding the Space Arrangement in the Working Environment of the Dentist
This study evaluated the ergonomic conformity regarding the spatial arrangement of dental workspace installed in the Basic Units of the Unified Health System (SUS), in Brazil. We created a checklist with ergonomic requirements provided by ISO / IDF 4073:2009 and further information from the literature and suggested by researchers in the field. We analyzed 40 dental workspaces verifying the compliance level to the requirements of 17 checklists. It was found that there is predominant frequency in the Regular category (23 dental workplaces - 57.5%) and Poor category (15 dental workplaces - 37.5%) and in only 2 dental workplaces (5%) the compliance level was categorized as Good. None of the dental workplaces presented a compliance level categorized as Excellent or as Very bad. The level of compliance of the space arrangement presented is considered low. Corrective measures and suitability are relatively complex because large structural changes are required.
Eliel Soares Orenha a, Wilson Galvão Naressi a, Suely Carvalho Mutti Naressi a, Symone Cristina Teixeira a, Enzo Rosetti a, Benevides da Silva Porfírio Junior a, Angélica Cristiane Bulio Soares b, Marcelo de Castro Meneghim b
Open Access
Article
Conference Proceedings
A Systematic Approach to Providing Accessible Electronic Communication
Legislation enacted throughout the world requires government agencies and affiliates to make electronic and information technology for internal and public use accessible to people with disabilities. Ensuring an awareness of the law and compliance with it requires a multi-part process, including advertisement, training, retro-fitting, template and instruction development and follow-up review. The regulations are under almost constant revision, as technology innovations require additional consideration. While checklists and automated tools are available, they do not necessarily guarantee compliance with the most recent guidelines. This paper presents a systematic approach for consideration in organizations that are required to comply with accessibility laws.
Nancy J. Lightner
Open Access
Article
Conference Proceedings
Superficial Electromyography and Motion Analysis Technologies applied to Ultrasound System User Interface and Probe Ergonomics Evaluation
The present work describes the ergonomics and usability preliminary tests regarding the human upper limb kinematics and strength evaluation of two diagnostic portable ultrasound scanners. The tests were performed by one expert sonographer in vivo on one subject in abdominal and vascular clinical applications and in vitro using a dynamometer. The two portable systems had different user interfaces and probe design: one system had traditionally-designed probes, a classic Soft keys interactive Menu, placed in the lower part of the screen, with toggles and buttons for the activation and adjustment of the functions, then a physical qwerty keyboard and a control panel. The other system had appleprobe-designed transducers, a touch screen integrated in the control panel with an interactive user interface and reduced number of physical buttons. Comparisons between the two systems considering the sonographer’s use are provided. Motion Analysis and Superficial Electromyography results will be presented and discussed on both systems regarding tests in vivo and in vitro only concerning Superficial Electromyography.
F. Vannettia, T. Atzoria, G. Pasquinia, L. Forzonib, L. Modib, R. Molino-Lovaa
Open Access
Article
Conference Proceedings
Aerodynamics and Biomechanical Optimization of the Jump Phase in Skiing, Through a Simulation-Based Predictive Model
In this paper, an aerodynamic and biomechanical evaluation of the jump phase in downhill race is presented. The aerodynamic analysis has been conducted in order to develop a predictive model of the lift and drag forces during the different jump phase. The jump time is very short and performed with high speed. The Biomechanical Analysis has been conducted using Santos Digital Human Model to simulate 5 selected postures measured with a motion capture system, in order to verify the reliability of the simulation software. These simulated postures generated data about frontal surfaces that have been used in order to validate the predictive models. The evaluation of the distribution of the joints torques produced on the athletes in the different posture, in response to the dynamical model of the jump in skiing, has been computed. Results demonstrate that the simulation model is effective and the simulated posture are coherent with the real motion measurement. There is a good agreement in Torques results for both the Skiers, in the different postures, with some exceptions. This is probably due to the fact that, even if the analyzed postures are the same for both the athletes, there is a natural variability in the executions, like the motion capture analysis demonstrates.
Marco Mazzola a, Alessandro Aceti b, Giuseppe Gibertinib, Giuseppe Andreonia
Open Access
Article
Conference Proceedings
Using Simulation to Provide Insights into the Concept Development of Patient-Centered Care Services
The United States’ Institute of Medicine established patient-centered care as an aim for the 21st-century health care system. Patient-centered care focuses on the patient, their family members and staff experience, while ensuring patient safety and high clinical quality. A medical center in the Veterans Affairs healthcare system approached the Veterans Affairs Center for Applied Systems Engineering to assist in the redesign of the facility that provides medical cancer care. Their goals were to design a patient-centered, state-of-the-art center. Discrete event simulation provided rough order of magnitude estimates for facility and resource planning. Primary metrics of concern were patient length of stay, patient wait time, and room and staff utilization. The simulation included an animated visualization of ‘a day in the life’ of a patient. It also collected metrics on patient experience and center efficiency. Watching the patient flow animation provided two primary insights to the stakeholders. First, it was evident that the patient care process was patient-centered in that it limited patient movement. Second, observations of traffic flow indicated that the design can accommodate the desired patient demand. The visualization showed that increasing the number of providers resulted in reductions in patient wait times and that reducing the number of exam rooms did not significantly affect patient wait time. This exercise demonstrated the value of simulation in the planning and analysis of facility configurations when considering patient-centered design.
Jason Cadwalladera, Steve Mellemab, Nancy J. Lightnera
Open Access
Article
Conference Proceedings
The Logistics of Distributed Aged Care in a Local Swedish Community
In an attempt to map the pattern of care contacts between +65 year olds with multiple medical diagnoses living at home and their formal and informal care and service providers, 62 persons in the local council of Haninge agreed to keep a diary of all their health related contact events for a period of 6 months. The participants were visited once a fortnight and their diary inputs were recorded. The data was collected during 2011, 2012 and 2013. 20 000 contact events and 28 000 activities were recorded over 10620 participant days. Background variables like marital status, type of dwelling, type of medical problems were related to patterns of contact with health care staff, transport services, type of care services provided, importance of family and informal care providers. The result is a fairly detailed description of the logistics requirements in a system of distributed aged care with high accessibility and retained independence.
Tore J Larsson
Open Access
Article
Conference Proceedings
Music Therapy as an Interactive Rehabilitation Tool for People with Alzheimer’s: Ergonomical Issues
The aim of this paper is to report the process to develop a new interactive tool for Alzheimer disease that utilizes music therapy. It is a design approach based on users’ needs, which involves the collaboration between patients, doctors, music therapists and designers, in order to develop a tool that can effectively works with patient’s memories. The work process was based on a multidisciplinary approach, and demonstrates how it is possible influence in a positive way different kind of patients, stimulating their lost memories with a new music therapy tool. The analysis work about the patients’ mental health, and their musical memories, was a fundamental part of the design process; the integration of new technologies – and the acceptance of those -, was one of the first goals that we wanted to achieve during the interaction between the product and the patient. With the assistance of an expert in music therapy, we have been able to integrate traditional tools for medical evaluation of memory and cognitive deterioration with new stimuli from the past life memories. When we finished designing the product, we conducted an evaluative test; this is the methodological process that we used to conduct it:a. Preparation:Setting: a room with no distractions, in order to create a relaxing environment that would not distract the patient’s attention.Staff: Music therapist / psychologistInclusion criteria: patients suffering from dementia (Alzheimer's) MMSE score = 15-20 (intermediate phase).We have chosen the interaction with patients undergoing intermediate because, since they still have good verbal expressive capabilities, they could directly, and more easily, provide important insights and analysis reflections.b. Tracks selection:6 tracks were needed in order for the test to take place; those tracks needed to be known and significant to the test subject. Tracks were selected following the directions of the medical director of the facility. We selected 30 tracks: in this way it would have been possible to select the 6 that would suit the patient best. The songs were divided into three categories: classical, traditional, light jazz.c. TestTo establish a communication channel linked to the archaic manipulation and sounds, from which arise the emotions of the person, speaking on the same conducting sound variations .After explaining in simple words what the object is, it is asked to press one of the buttons placed on the faces of the cube.After the button is pressed, a song previously selected is played; the therapist asks to the patients if he knows the song and if he likes it. After the patient has familiarized with the object, he is asked to press a button he has already pushed; then the therapist asks if he recognizes the song associated to the same button.
G. Andreonib, A. Carpentieroa, F. Costaa, S. Muschiatoa, L. Spreaficoc
Open Access
Article
Conference Proceedings
Visual and Spatial Rehabilitation for Elderly in a Sensorial Path
The elderly population affected by Alzheimer’s disease presents many dysfunctions related to the course of the degenerative disease. Some of these disorders are treated with physical and cognitive rehabilitative the-rapies. In order to help and develop the therapies, the article explains the project of a new modular rehabilitative platform and the test made on it using Alzheimer’s patients. The test conclusions show that the patients interact with the sensorial, visual and tactile stirrings provided by the platform; the repetition of these stirrings through exercises can lead to a longer maintenance of the perceptual functions. The article describes the first step to a neurological rehabilitation for Alzheimer’s and a walk rehabilitation for elderly people with balance problems.
G. Andreonic, F. Costaa, S. Muschiatoa, L. Spreaficob, D. Tinèa
Open Access
Article
Conference Proceedings
Tailoring Motivational Mechanisms to Engage Teenagers in Healthy
Overweight and obesity are the first leading risk related to nutrition for global deaths, in the last few years it outranked the famine. Obesity increases the risk of several debilitating, and deadly diseases, including diabetes, heart disease, and some cancers. Due to the many health risks associated with obesity, the financial burden that the treatment of this disease exercises on the European healthcare system is enormous. For this reason, the best strategy relies in prevention. In particular, the pervasiveness of technology can leverage an important advantage for the promotion of healthy behaviors in the new generations. This paper introduces PEGASO, a technological multidisciplinary project funded by the European Commission that aims at creating an ecosystem that can enable teenagers to adopt healthy habits leading to a healthy life-style. The ICT system plays an important role in the PEGASO ecosystem. This behavior change support system integrates a Virtual Individual Model that allows characterizing the physiological status, physical condition and the psychological status for each user. This allows the elaboration of tailored interventions aiming at promoting the adoption of healthy habits by the users. This paper describes this concept introducing the Virtual Individual Model and discusses the possible interventions related to the promotion of physical exercise and of healthy dietary habits. At the end of the paper, some indications about the future development of the PEGASO project are provided.
Life-Style: A Concept
Open Access
Article
Conference Proceedings
Evaluation of Professional Ultrasound Probes with Santos DHM. Handling Comfort Map Generation and Ergonomic Assessment of Different Grasps
Sonographers’ work-related musculoskeletal disorder is a critical but often neglected problem, with reports indicating that approximately 80% of them experience pain from the extended use of sonography probes. Also transducer design can be a common cause of hand-wrist complaints. Moreover, there are many opportunities to minimize the risk of musculoskeletal disorders. A possible solution was proposed by Esaote, whereby the probe-handle shape is redesigned with a more ergonomically effective profile, appleprobe Design, that can be used with two or more different handling positions. This paper presents: details of this new design, where 6 different probes were analyzed experimentally for ergonomic purposes; virtual analyses of the evaluation of the contact surfaces (hand/probes) for each probe and each grasp, using an advanced Digital Human Model (DHM), Santos, and results of experiments to evaluate actual user discomfort. Results indicate the advantages of the proposed design and an acceptable correlation between the virtual and the experimental analyses. This work represents the first step towards the use of Santos DHM not only for comfort/ergonomics evaluation/validation after the production of the probe, but also for the simulation of new design concepts before prototypes are even manufactured, thus reducing production costs and improving quality.
M. Mazzolaa, L. Forzonib, S. D’Onofriob, T. Marlerc, S. Becksd
Open Access
Article
Conference Proceedings
An Innovative Bike for Children Play and Rehabilitation
Design is strategic for rehabilitation engaging and social inclusion. According to this vision, we developed a bike to promote physical and ludic activities among children, with great care of the needs of children with Cerebral Palsy. Regular physical activity, such as cycling, improves their health condition, and specifically strength and cardiorespiratory performances. A bike adds to the benefits of physical activity, the opportunity to perform outdoors rehabilitation and to socialize with other children. The methodology started with a deep analysis consisting in several steps: literature and patents research, direct observations, questionnaires and interviews of all involved users (children, parents, clinicians). A new bike was designed and developed and some tests were performed. These tests were addressed to children (with or without CP), to their parents and physiotherapists, in order to understand if the new bike was useful, safe and desirable.
Carlo Emilio Standolia, Maximiliano Romeroa, Giancarlo Vazzolerb, Giuseppe Andreoni a
Open Access
Article
Conference Proceedings
The Building of a Virtual Individual Model (VIM): Multi Domain Characterisation of Health Status in the PEGASO Project
The recent European strategies for the improvement of citizens’ health status largely rely upon the promotion of technological solutions that empower the individual as a co-producer of his/her health through the management of personal life conditions, with a user-centred approach. The efficacy of this approach is enhanced by a detailed and accurate modelling of knowledge concerning the individual's health requirements. Moreover, the adoption of a Virtual Individual Model (VIM) including biological, cognitive and social aspects in the framework for health status characterisation may lead to a stronger empowerment of the user through a more individualised strategy of health management. Purpose of this work is the presentation of a VIM structure suitable to describe obesity related phenomena in children and adolescents. The model includes physical, physiological and psychological domains which are ruled by specific behaviours and influenced by societal externalities, and ultimately concur to the concept of whole individual's health, defined as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity". It is assumed that health status is primarily settled on elements of physical status of body structure (comprising body size and composition attributes), physiological status (comprising metabolic parameters related to alimentary habits and functional responses to exercise) and psychological status (based on relevant characteristics of personality). Body structure and functionality are influenced by the individual's behaviours in the domains of alimentation and physical activity, which are driven by relevant aspects of motivation. Social status, social behaviour and psychological status (i.e. the psychosocial factors) are considered in the model as important determinants of behavioural skills as well as attitudes and motivation to engage in healthy lifestyle behaviours. In such a context, status and behaviours in the different domains can be defined by appropriate profiling including parameters relevant for quantitative characterisation and detection of changes, whereas motivation for healthy lifestyles can be evaluated through changes in alimentary and/or physical activity behaviours. Thus the VIM results to be built on profiles spanning from physical to psychological and social domains and include aspects of different behaviours, each component of the model being modifiable by the other components and determining dynamically the individual's health status. The so defined VIM will be suitable to be handled with ontology-driven tools allowing to outline the semantic relations between the different elements in the biological, cognitive and social domains and dynamically enabling inferences over individual-related parameters spanning through the different domains. Moreover, the use of VIM within the PEGASO project, will facilitate the creation of both the whole multi-dimensional and cross-disciplinary ICT system architecture as well as the development of dedicated reasoners for the inference of the health status and the promotion of alimentary-/exercise-related healthy behaviours, relevant for overweight and obesity prevention in the juvenile age.
Claudio L. Lafortunaa, José C. E. Serranob, Neil S. Coulsonc
Open Access
Article
Conference Proceedings
Participatory Workplace Development for Disabled Workers Reintegration
The aim of this paper is to report the process conducted by an interdisciplinary team to develop an accessible and satisfactory PC workstation to be used by physically impaired people for their professional reintegration. A biomechanical, ethnographic and participatory approach has been applied to occupational ergonomics in order to integrate qualitative and quantitative analysis methods. On the basis of these results an iterative process of prototype development and user testing has been conducted which led to the refinement of an adjustable workstation as adaptable as possible to different users pathologies and office activities. The experimented multicompetence approach has been able to integrate different research methods into a research strategy providing a more comprehensive understanding of the analyzed phenomena and increasing the quality of final results.
Andreoni G., Costa F., Dall’Amico M., Frigo C., Gruppioni E., Muschiato S., Pavan E., Piccoli, M., Romero M., Saldutto B.G., Standoli C.E., Verni G., Vignati G.
Open Access
Article
Conference Proceedings
Biomechanical and Qualitative Study of a Multiple Adjustable Shower Trolley
The purpose of this study was to compare the traditional height-adjustable shower trolley with a shower trolley with a new design. Compared to the traditional height-adjustable shower trolley, this version had higher side supports, indented curves on the long sides, handles, arrow-shaped ends, and a mattress with a flexible mid-section. In this study four nurses carried out five shower cycles using the traditional height-adjustable shower trolley and five shower cycles using the new design. These activities were filmed and analyzed by multi-moment sampling at a fixed interval. Each observation consists of a back score, arm score, leg score and neck score. Results show that working with the new design leads to less postural stress on the musculoskeletal system of the caregiver, compared to the traditional height-adjustable shower trolley. There is a 10.2% improvement in time spent in a neutral back position and a 9.4% improvement in the time spent in a neutral neck position. The main focus of the study was on the postural analyses. Nevertheless the qualitative aspects analyzed deserve attention as well and might be just as valuable. In practice they may determine the frequency with which a device is used, as nurses tend to be more motivated if the patient is more comfortable and the quality of care is higher. The new device was experienced as more dignified, comfortable and warmer.
Hanneke J.J. Knibbe a, Nico E. Knibbea, Elly M. Waaijerb
Open Access
Article
Conference Proceedings
A 5-Category Classification System for the Design and Planning of Healthcare Facilities
In order to implement programs to prevent back pain in caregivers, assessment of the degree of passivity and mobility of patients is imperative. After all, the load in health care ergonomics is often the patient. The degree of cooperation or resistance determines the load on the back for the caregivers and the necessity of the use of lifting devices like patient lifters or sliding sheets. It also has its impact on the choice of equipment to carry out daily hygienic care. These assessments must be done in both a practical and a reliable way. One of the major problems encountered in health care during the process of implementing ergonomic changes is the lack of space. There is often not enough space to work with larger equipment like patient lifters and shower chairs or other medical devices necessary in a preventive program. This leads to undesirable extra physical load for caregivers. The Mobility Gallery, a validated 5-category classification system, is now used to define in a structured manner the existing and future population of a healthcare facility and supports the planning and space design. Based on the assessment of mobility levels, the equipment needed can be defined. All transfers and care activities are shown in a bird’s eye view image and are translated into functional areas. This tools will encourage architects to build in the future in such a way that one of the corner stones of a safe patient handling program, sufficient space, is guaranteed.
Elly M. Waaijer a, Hanneke J.J. Knibbe b
Open Access
Article
Conference Proceedings
Medical Device for Patient Immobilization and Repositioning During Proton Therapy Treatment
Proton therapy is a type of particle therapy which uses a beam of protons to irradiate diseased tissue, protons accelerated by a cyclotron (or synchrotron) are concentrated on the neoplastic tissue with highest precision.Results of proton therapy are actually considered better than those from conventional radiotherapy, chemotherapy and surgery, concerning the elimination of the neoplasm and thanks to lower incidence of possible side effects. To get the best benefit from this treatment, it is very important to irradiate, the same point, with the same intensity during each treatment session. This objective could be quite complex to be achieved and for that reason the design of such device was carried out through a complex anthropometric and usability analysis.ITEL Telecomunicazioni develop a new Bed Positioning System for proton therapy thanks to which it is possible to obtain, in addition to the immobilization, a perfect repeatability of the position assumed by the patient during treatment. Particular attention has been paid to patient positioning procedures, developed to be as quick as possible by the use of a restraint devices connected directly to the table. Ergonomic study and platform design, developed with CETMA collaboration, allows its use by a wide range of different users.
Luca Rizzi, Ubaldo Spina a, Cinzia Dinardo b, Vincenzo Dimiccoli c
Open Access
Article
Conference Proceedings
Development of Medical Device UI-Profiles for Reliable and Safe Human-Machine-Interaction in the Integrated Operating Room of the Future
Nowadays, the number of technical systems in the operating room increases constantly. This ongoing spread of technology has significant impacts on the individual working process steps of the surgical team. Besides improving the therapeutic quality, these changes may also lead to new human-induced risks for patients, therapists and third parties. In particular, within intra-operative activities, which depend on a safe and fast operation, surgeons and nurses rely on sophisticated and efficient solutions in terms of Human-Machine-Interfaces in order to perform their tasks reliably and assuredly. Therefore, proprietary integrated workstations with a central usage cockpit have been provided for the operating theatre in recent years. At the Chair of Medical Engineering, a surgical integrated workstation with open interfaces for the integration of various medical devices from different manufacturers is currently been developed in the context of the BMBF (Federal Ministry of Education and Research) funded project OR.NET. For this purpose a suitable central user interface (e.g. multi-function foot switch, touch screen, diagnostic monitor, etc.) will be implemented, in a way that the functions of the various (networked) devices can be offered to the user by a central user interface. The design of the Human-Machine-Interface therefore depends on the available input and output devices, the interaction elements of the graphical user interface, the available medical technical equipment, as well as the medical intervention and the particular process steps and the environmental conditions within the operating room. In this work, a concept for the development of a Medical Device User Interface Profile (UIP) will be presented, using the characterization of process-dependent medical device functions for the modular design of a central user interface in the integrated operating room of the future. The use of standardized UI Profiles should allow the manufacturers to integrate their medical devices, respectively the provided functions in the OR.NET network, without disclosing the risk analysis and related confidential know-how or proprietary information. The UI Profiles will allow both, an automated optimized selection and composition of various user interfaces, and implicitly an optimal design of a central GUI with respect to the criteria of usability and an integrated human risk analysis in terms of Human-Machine Interaction. Specific operation process steps within a neurosurgical workflow will be the framework for the validation process of the UI Profiles. Till now, the UIP concept has been tested within the integration of an ultrasound dissector and an OR microscope.
Armin Janß, Julia Benzko, Paul Merz, Jasmin Dell’Anna, Melanie Strake, Klaus Radermacher
Open Access
Article
Conference Proceedings
A Proposal of Feature Extraction Method for Press-Through-Package Designs Based on Fourier Transformation
In order to prevent medical accidents which originate in using drugs, we need to properly use proper drugs. In Japan, we often use PTP (Press-Through-Package) sheets as a packaging unit of medical drug tablets. In order to prevent PTP sheets from design confusion, we need to establish the method to estimate the similarity of PTP sheets. In this paper, in order to acquire the knowledge about characteristics of PTP design, we applied Fourier transformation to PTP design. Under the assumption that marks and string letters in the design can be approximated into rectangles, we defined the (approximated) function that expresses PTP design. The function consists of a prototile, expressing a layout of rectangles, and its copies. We found Fourier transformation of the function can be expressed as the product of a contribution from the layout of the copies and a contribution from the prototile, the latter of which is found to have large value along lines perpendicular to line segments connecting centers of the rectangles at the center of the FFT image of a PTP design. Based on our discussion and the results of experiments, we obtained the knowledge that the similarity index of PTP design should consist of the similarity of prototiles in PTP sheets in low spatial frequency region and the similarity of the layout of prototile copies.
Yuuki Hosozawa, Masaomi Kimura
Open Access
Article
Conference Proceedings
The Ergomedical Design: Integrating a Medical Approach into the Innovative Design Process
Ergonomics, usability and user-centered design are terms that are well known among designers. Yet, products often seem to fail to meet the users' needs, resulting in a gap between expected and experienced usability. Prospective users of a new design in the area of everyday products offer innumerable opportunities for measurement and observation, in view of both the diversity in user populations and the freedom of where and how to use a product. In this research we wanted to show the impact of integrating a medical approach with an ergonomic approach to create a new sphere of innovation. This is what we called the Ergomedical design. This design process allows innovating protection concepts, but also in the wellness or human performance. All the examples are in the field of physical activity. We illustrate the integration of medical experts and their approach to innovation and design product with an innovative concept of earplug. Generally, it's explained that earplug protects of environment (pollution), water and maybe the cold (or wind). But the problem for users is not pollution, water or cold but the otitis and the exostisis. So with our medical team, we decide to change our approach and develop an earplug, which protects patients about otitis and exostisis. With this new design approach, a new concept of earplug was born. During the conception, the medical team has validated or not the different designs with medical arguments. The first test has been centered about the health used of the product on extreme condition. We have tested this product during many days and every tester has kept the earplug in his ear during 6 to 8 hours by days. Our medical manager has tested a non-irritability of this product. To finish we have tested this earplug during one year in order to prove the concept efficiency to prevent the otitis and the exostisis. Ergonomic tests have proved the comfort, the fit design and the good adaptability for the sport practice. The Ergomedical concept completes the ergonomic and user's centered approaches to design new product.
Virginie Rosa a, b, Franck Handgraaf a, Jean Sayeuxc, Brice Pereyred, Frédéric Cordiere
Open Access
Article
Conference Proceedings
Stochastic Resonance Training at Work Reduces Musculoskeletal Pain in Nurses
This randomized controlled trial (RCT) reports effects of a preventive intervention at worksite, namely stochastic resonance whole-body vibration (SR-WBV) training on musculoskeletal pain (MSP). SR-WBV is a form of whole-body vibration training with randomized low frequency vibration. The force-time behavior of the vibrations is not foreseeable and the body will be constantly challenged to adapt the muscle reactions. The experimental group (EG) performed an eight-week of SR-WBV. The control group (CG) received no intervention. The RCT was conducted in a large Swiss hospital. The 180 participants were between 18 and 63 years old (M = 43; SD = 11). The majority were female (88%) and were nurses (45%). MSP was measured daily in a diary. Participation possibilities and general health were assessed by self-report questionnaires before the RCT started. A longitudinal multilevel analysis showed a significant interaction of SR-WBV by time showed MSP to decline in the EG. Moreover, SWBV-training reduced pain to the largest extent in those with lowest participation possibilities and those who reported only moderate general health. Thus, SR-WBV was most effective in those reporting risk factors for musculoskeletal pain. SR-WBV may help to reduce the high prevalence of occupational musculoskeletal pain in hospital staff.
Achim Elfering, Volker Schade, Christian Burger, Lukas Stöcklin
Open Access
Article
Conference Proceedings
Telehealth Technology Enabling Medication Management of Children with Autism
To assist healthcare providers in the management of autism symptoms, a new smartphone application was developed that now allows physicians to observe patient behaviors between office visits, and allows physicians to manage a patient’s medication based on the severity and dynamics of the symptoms observed. A technology evaluation was conducted to determine ease of use of the smartphone application by two physicians and three caregivers of autism patients. The results showed that the new smartphone application is able to assist the physician in monitoring patients with an autism spectrum disorder more accurately than when using subjective reports provided by caregivers during office visits. The smartphone application technology demonstrated a potential new way to help both caregivers and physicians in improving medication management for children with autism.
Uwe Reischl a, Ron Oberleitner b
Open Access
Article
Conference Proceedings
Dual Patient – Healthcare Provider Experience Mapping and Implications for Information Technology Deployment and Clinic Layout
The implementation of information technology, in general, and electronic medical records (EMR), in particular, can have implications on various aspects of the healthcare process. This paper describes the development and implementation of a dual experience mapping technique to identify the mutual experience of patients and their families, on the one hand, and healthcare providers, on the other hand, as part of the preparation for deploying a new EMR system in a hospital environment. The dual experience mapping focused on identifying mutual pain points associated with the use of the new system as a function of various physical locations within hospital clinics. The findings facilitated the identification of mutual needs and definition of solution directions. Specifically, the recommendations addressed the layout of clinics with the deployed system in a way that addresses identified pain points and needs. The effectiveness of using the dual experience mapping is demonstrated in this project as a technique that can help in patient-oriented design and patient empowerment in healthcare.
Avi Parush, Maya Lorenco-Levin, Catherine Campbell
Open Access
Article
Conference Proceedings
User Empowerment in Telehealth Practice: The TeleSCoPE Project Approach
Over the last two decades the use of telecommunication technology has grown popular in clinical practice and healthcare management all over the world. Its spreading, originally aimed at reaching remote areas, has been promoted by the anticipation of a major demand of telehealth services, wedded to the reduction of the availability of economical resources. At present, telecommunication technology offers solutions ready to cover the most diverse health-related issues, and the needs of society as a whole. Simultaneously to the development of the tele-support to traditional care, various debates regarding new possibilities offered by at-a-distance provision of healthcare have cropped up. Jointly rose from the ranks the need for alignment, both within and between the European nations, of the standards for the rising services, in order to facilitate their further use and to create trust around these new born means. The European project TeleSCoPE – Telehealth Service Code of Practice for Europe - is positioned in this framework. The European Code of Practice for telehealth services, the main output of the project, addresses tutelary issues evaluated and agreed among telehealth agents, in a user-centered view. Researching the different aspects related to user safety and satisfaction, rose the issue concerning the role of the users towards their health. The empowerment of the user is such a central matter that it led the partner group to the creation of an unambiguous glossary, where the top-down term “telemedicine” is replaced by “telehealth”, highlighting the excess of the merely clinical approach, in favor of an interaction between service provider and user/carer aimed at health in its wider and more comprehensive meaning, then covering social, psychological and physiological aspects, as well as well-being.This paper discusses the core of the TeleSCoPE Code of practice, regarding user empowerment, and provides a small review about the acceptance, the appreciation and the efficacy of personal involvement of users/patients in the provision of healthcare, according to the available literature
Sarah A Tabozzi a, Malcolm J Fisk b, Frederic Lievens c
Open Access
Article
Conference Proceedings
Maladaptive Back Beliefs and Low Back Pain in Nurses: A Longitudinal Study
This population-based longitudinal questionnaire study examined whether back beliefs predicted increased low back pain (LBP) one year after baseline, comparing the phenomenon in nurses versus other participants. A random sample of 2’860 individuals participated. At one-year follow-up 1’445 questionnaires were returned. At baseline and follow-up, back beliefs were assessed with the Back Beliefs Questionnaire (BBQ) and LBP was assessed using a standardized pain intensity item and pain manikin. Cross-lagged structural equation modeling was used to estimate the prospective risk path from BBQ at baseline to LBP at follow-up. A model comparison test evaluated whether paths differed between 59 nurses and 1’383 other respondents. The cross-lagged path model fitted the empirical data well (CFI = 0.91; RMSEA = 0.04). In nurses, the longitudinal path from BBQ to LBP at follow-up (β=0.30, p=.013) and the cross-sectional association between BBQ and LBP at follow-up (β = 0.42, p = .031) were more positive than in others (longitudinal path: β = 0.05, p = .023; cross-sectional path: β = 0.06, p = .062). The biopsychosocial model of LBP and maladaptive back beliefs should be addressed in educational occupational health interventions for nurses.
Achim Elferinga, Cornelia Rollia, Urs Müllerb, Özgür Tamcanb, Anne F. Mannionc
Open Access
Article
Conference Proceedings
Development of Telemedicine in Oil & Gas through the Capabilities Approach
The oil & gas companies operating in the Norwegian Continental Shelf have commonly used the capabilities approach within the context of Integrated Operations. This approach focuses on understanding organisations as dynamic systems and provides concepts and a language for developing resources. Recent efforts are focusing on extending Integrated Operations and the capabilities approach to medical services offshore, specifically on the use of telemedicine. Telemedicine in this context involves the connection between offshore and onshore medical staff through the use of communication systems, as well the distribution of medical data obtained offshore (for instance HD images or vital signs readings). In this work we describe the elaboration of a new tool: the Capability Development Resource Matrix, based on the People - Capability Maturity Model (P-CMM) proposed by Curtis, Hefley, and Miller in 2009. This tool is designed to guide organisational development and is generated directly from the work with industry partners, being continuously tested and improved. We discuss the tool’s value for planning, development, and implementation of telemedicine in Oil & Gas and other contexts. We wrap-up with considerations about future steps in the methodology conception and evaluation.
Alexandra Fernandes, Kine Reegård, Asgeir Drøivoldsmo, John E. Simensen, Grete Rindahl
Open Access
Article
Conference Proceedings
Development of an e-Healthcare System for University Students
An e-Healthcare system with IC card authentication, automatic health screening subsystem and Web-based health information monitoring, has been designed and implemented for university health education. It is a prototype of private Cloud service of e-Healthcare for university students which can obtain their health records from physical measuring devices with their IC card-based authentication, manage their health data in suitable database, investigate such data from viewpoint of doctors/nurses and provide such information for self-healthcare controlling through Web-DB service. This paper presents an organization of the above e-Healthcare system, demonstrates its real usages in university health education and describes its brief evaluation and expanding plan through practical applications.
Yoshiro Imai*, Eiichi Miyazaki**, Hiroshi Kamano***
Open Access
Article
Conference Proceedings
Physicians’ Work Hours and Patient Safety in a Norwegian Context
There has been growing attention in society to the question of whether physicians’ work hour regulations constitute a challenge to patient safety due to extended work hours. The aim of the current study is to examine the practice of work hour regulations in a Norwegian context and explore possible risk factors by employing a qualitative case study design in a surgical hospital department. The study results emphasise that both framework conditions and work hours in the current work environment must be taken into consideration when assessing the risk of adverse events. Findings show that work hour regulations are violated more or less continuously in the current surgical department, especially during holiday periods. Despite this, the informants value the work load within existing work hour regulations as more influential when explaining the effects on patient safety than the work hour regulations themselves. Contextual factors such as workforce situation, coincidental work tasks, and safety awareness are seen as important framework conditions. We argue that the current practice with extended work hours (>12h) during night shifts constitutes a potential risk factor, a finding that is also supported by international research studies on work hour effects.
Kristin Alstveit Laugaland, Karina Aase
Open Access
Article
Conference Proceedings
Arm and Neck Pain in Ultrasonographists
The aim of this study was to evaluate the prevalence of upper body quadrant pain among ultrasonographists and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. A hundred and ten Belgian and Dutch male and female hospital ultrasonographists were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions about ergonomics, symptoms and work related factors. Subjects with the screen on their left had significantly more neck pain. Depending on the work space, high-low tables increased the chance on developing neck pain. A screen on eye level caused less neck. Employees with a fixed working space were less susceptible to arm pain. The prevalence of arm pain was significantly higher on the vascular department compared to the radiology, urology and gynecology departments. In the prevention of upper limb pain in ultrasonographists, attention should be paid to the work environment in general, and to the more specific aspects of the ultrasound workstation layout. Primary ergonomic prevention could help the ultrasonographist to work painless during his medical tasks.
Frank Claesᵃ, Jan Bergerᵇ, Gaetane Stassijnsᵃ
Open Access
Article
Conference Proceedings
Study on Burnout Syndrome within the Portuguese Firefighters Population
The purpose of this study is to contribute to a better knowledge of the Burnout Syndrome within the Portuguese firefighter population. It will also refer to the relation between Burnout and work satisfaction. Despite the overall intention of the work is to study the entire Portuguese firefighter population, in this stage, only a sample of 39 elements from the operational corps within Alcabideche Firefighter Volunteers was studied.The investigation follows the model of analytical epidemiological studies used to exam associations formed by hypothesis of casual relation. The main intention is to identify, or measure de risk factors and its effects on the health of the operational firefighter referred. It was used a cross-sectional analytic study, as it analyses, on a particular moment one specific population, trying to establish correlations and interferences between selected variables chosen regarding its importance on the firefighters health. It was used a specific questionnaire adapted from the MBI method.The analyses results appointed for no significant statistic correlation between Gender, Age, and Working hours and the three dimensions of Burnout: exhaustion, cynicism and professional efficiency. This may be explained by the possible existence of protection factors: social support, proper working conditions and good relationships among colleges.
Paulo Gaspar, Miguel Corticeiro Neves
Open Access
Article
Conference Proceedings
Working Conditions of Health Technicians in Ceará’s Public Health System
The study aims to analyze the working conditions of health professionals of Basic Health Units (BHU) of Fortaleza, Ceará, Brazil. BHUs are primary health care units that are the front door of the national public health system. The research analyzes working conditions of primary care auxiliary and/or technicians and their perceptions regarding working conditions and harassment. It is a cross-sectional survey of exploratory nature, using quantitative and qualitative methods. 120 mid-educational level background workers answered a questionnaire containing socio-economic information; an occupational stressors scale and the Negative Acts Questionnaire (NAQ). Nine technicians and auxiliaries participated in individual interviews. Observations of workplaces were also done. 2.5% of participants declared to have suffered workplace harassment. However, 11.7% reported negative acts towards them, weekly or daily in the last six months. The participants perceive their working conditions as precarious. They report employment instability, lack of equipment, low salaries, and long working journeys. They appear to worry about exercising their activities with prejudice to the services’ quality and to their health. The study points to the need for actions that bring egalitarian conditions in terms of employment to this category of workers, better working conditions, and financial and social recognition.
Regina Heloisa Maciel, João Bosco Feitosa dos Santos, Ana Paula Torres do Nascimento
Open Access
Article
Conference Proceedings
Healthcare System Focusing on Emotional Aspect Using Augmented Reality: Emotion Detection by Facial Expression
Current research includes many proposals of systems that provide assistances and services to people in the healthcare fields; however, these systems emphasize the support physical rather than emotional aspects. Emotional health is as important as physical health. Negative emotional health can lead to social or mental health problems. To cope with negative emotional health in daily life, we propose a healthcare system that focuses on emotional aspects. This system provides services to improve user emotion. To improve user emotion, we need to recognize users’ current emotional state. Therefore, our system integrates emotion detection to suggest the appropriate service. This system is designed as a web-based system. While users use the system, facial expression and speech are detected and analyzed and to determine the users’ emotions. When negative emotions are detected, our system suggests that the users take a break by providing services (designed to provide relaxation, amusement and excitement services) with augmented reality and Kinect to improve their emotional state. This paper focuses on feature extraction and classification of emotion detection by facial expression recognition.
Somchanok Tivatansakula, Gantaphon Chalumpornb, Supadchaya Puangpontipb
Open Access
Article
Conference Proceedings
Human Factors and Ergonomics in Mobile Computing for Emergency Medical Services
Emergency Medical Services (EMS) are an essential part of pre-hospital medical care. While paper-based tools and organizational workflows are still the status quo in this field of application, they are increasingly replaced or complemented by telemedical solutions and mobile computer-based documentation and information systems. Enhanced data quantity and quality as well as a more pervasive flow of information are benefits associated with these developments. Less frequently it has been emphasized that from an emergency physician’s or paramedic’s point of view, introducing mobile computing changes the tasks that have to performed and mastered. Considering both the system and the personal view is important for developing usable approaches to pre-hospital medical care. Time delays, faulty records or additional workload caused by usability deficiencies and poor human computer-interface design would not be acceptable neither for EMS employees nor patients. Furthermore, they would compromise the overall goals of different stakeholders, e.g. health authorities, insurances, hospitals and public safety organizations. Based on the experiences and findings during a two-year project with several EMS, we consider human factors and ergonomics in mobile computing for EMS from societal and cultural needs and expectations over group and individual behavior to ergonomics of physical devices.
Tilo Mentler, Michael Herczeg
Open Access
Article
Conference Proceedings
The Needs of Smart Medication Reminder for Elderly s
The increasing burden of chronic illness is currently a significant challenge due to the aging of the global population. For most people who suffer from chronic illnesses, lifelong treatment is needed for their health management. This study is focused on the needs of elderly people with chronic conditions who require lifelong treatment for disease management in taking medications as prescribed. A face-to-face survey and a multiple case study were conducted to elicit the reasons why elderly s use pill box and to determine the effectiveness of the smart medication reminder system. The results indicated that 60% patients need a tool for assistance in taking their medication as prescribed. The experimental results showed that the smart medications reminder may effectively assist users in taking their medications as prescribed. The patients’ needs for the smart mediation reminder include reminder design, mobile medication reminder, ease of use, flexible design, and Modular Design. By using the smart medication reminder, the pressure of taking medications as prescribed may be relieved for the most elderly users. Furthermore, economic, social support, and elder care subsidies are the important factors for patient welfare.
Fei-Hui Huang
Open Access
Article
Conference Proceedings
A Proposal of the Method to Identify Adverse Effects Based on Topic Maps
Medical experts need to properly identify the adverse effects. However, this is difficult for novice medical experts, since such identification need veterans’ knowledge. One may consider reading of package inserts is helpful, since they are sole authorized documents. However, the novice medical experts will also feel difficulty, since the number of drugs is huge. In order to identify the adverse effect, patients’ explanation about what they feel are usually helpful. However, the problem is that there is an semantic gap between patients’ explanation and medical knowledge about adverse effects. The variations of patients’ explanation also make it complicated to extract information about adverse effects from their words. In this study, we utilize information in drug information sheets and techniques of topic maps. We propose the method to extract adverse effect information from drug information sheets, to associate it with patients’ explanation, and to create a database which has the topic map structure. We assume three elements to describe both patients’ symptom explanations and initial symptom descriptions in drug information sheets. Moreover, we propose the method that starts from the three elements and follows the associations to find adverse effects.
Kazuya Yokokawaa, Masaomi Kimuraa, Michiko Ohkuraa, Fumito Tsuchiyab
Open Access
Article
Conference Proceedings
Using High Reliability and 'Lean' Thinking to Drive Excellence in Patient Safety: A Case Study from Radiation Oncology
A grand challenge for most radiation oncology clinics is to develop highly reliable systems that deliver value to every patient. We present a case study from the Radiation Oncology Department at the University of North Carolina (UNC) where we recognize that our systems are imperfect despite multiple built-in quality assurance (QA) steps to detect human errors. We took on a journey to organize our systems in such way that we are better able to notice the ‘week signals’ of human errors. We herein highlight previously-reported initiatives and demonstrate concurrent improvements in patient safety culture. In summary, this case study suggests that high reliability and ‘Lean’ thinking initiatives can be successfully implemented to yield measurable improvements in patient safety culture.
Lukasz Mazur, Bhishamjit Chera, Robert Adams, Lawrence B. Marks
Open Access
Article
Conference Proceedings
Analysis of a Transfer Device for Horizontal Transfers and Repositioning on an ICU: Effects on the Quality of Care and the Quality of Work
A new patient lifting device has been developed in close cooperation with the University Medical Center Groningen. This specially designed, transfer sheet (TS) for horizontal transfers and repositioning can stay under the patient at all times and is easily connected to a ceiling- or mobile lifter to facilitate quick and comfortable transfer- and repositioning activities which can be relevant in the complex environment of an ICU. Assumptions are that the device significantly improves the quality of care for patients and the quality of work for nurses. In addition to this, pilot studies indicate that the nursing time required for the transfers is significantly reduced. This, in turn, results in a decrease of occupational hazards and an increased efficiency and productivity of nursing work. Further research is necessary and this study intends to fill this need. In this paper the outline of the study is described (prospective, single center case study with a pre-post design in a clinical setting) and the first results. The post-intervention data are currently being collected and will be presented. The results of the biomechanical part of the study are available and indicate that the TS does result in a significant decrease in physical exposure for nurses by 1. reducing the physical load associated with specified transfers and 2. by eliminating the need for some specified transfers altogether. The effects are more positive when the TS is used in combination with a traverse ceiling-lifter system as opposed to either a single track ceiling-lifter system or a floor lifter.
Hanneke JJ Knibbea, Marisa Onrustb, Wim Dieperinkb And Jan Zijlstrab
Open Access
Article
Conference Proceedings
An In-Patient Nursing Documentation Application for Smart Phones
It is a widely known fact that mobile hardware and software technologies are exponentially evolving. Even though the health industry is taking advantage of these technological advances, very little has been accomplished from a nursing perspective of electronic medical records documentation applications. Nursing tasks remain mostly documented via rudimentary, inefficient, and time-consuming pen and paper methods. There is very little research literature regarding the use electronic devices for nursing documentation. In this article we describe a nursing documentation system implemented for the Android platform running on smart phones. The system is a successor of a previous PDA-based nursing documentation system. The general functionality of the original PDA-based system is described as well as the validation of the user interfaces of the system. The new smart phone-based system is described and at the same time contrasted with the PDA-based system in terms of their user interfaces and interaction paradigms. In general, the transition from the PDA version to the smart phone version was painless because it was possible to transfer most of the user interface paradigms from de PDA system and also reuse the database that held its electronic medical record. We expect the new system to be more agile in terms of interaction because of the improved interaction paradigms of smart phones and also because many nurses will be using it on a very familiar device.
Néstor J. Rodríguez, José A. Borges, Isabel Nájera, Joseph Marrero, Miguel A. Aleman, Carlos A. Rivera
Open Access
Article
Conference Proceedings
Collaboration Expertise in Health Care - Mapping the Mosaic of Shared Work Experience, Transactive Memory System and Performance
In all domains teams knowledge of the others team members’ expertise is of high importance and has been named transactive memory system (TMS). Especially in healthcare, where teams are often formed ad-hoc and the performance directly reflects patients’ wellbeing, the relationship between TMS, shared collaborative experience and performance needs to be examined. This study examines this relationship in the context of nursing. Knowledge about the teammate’s domains of expertise should only have a performance-critical impact in tasks innate to the own profession, while general collaboration tasks should not benefit from a strong TMS. 52 nurses of which about half had working experience together filled out a TMS questionnaire. Two groups of dyads (with and without prior shared work experience) performed one task of their own profession and one domain-general task. The results could show that performance in the working-domain specific task was higher in the group with shared experience than in the group without shared experience. No difference could be found in the domain-general task. This study adds evidence to the body of literature that collaboration is a domain-specific skill and that performance depends on it. Methodological implications to possibly improve TMS and collaboration expertise in teams are discussed.
Jan Kiesewetter, Fara Semmelies, Barbara Saravo, Martin R. Fischer, Birgit Wershofen
Open Access
Article
Conference Proceedings
A Fuzzy AHP Approach for Risk Assessment on Family Health Care Strategy
This paper presents an approach to support decision making in assigning risk rates for patients of spontaneous demands in the Brazilian Family Healthcare Strategy. This approach was elaborated based on concepts of the Fuzzy Set Theory and AHP - Analytical Hierarchy Process and implemented in a Primary Healthcare Facility in the City of Rio de Janeiro. Thus, the proposed approach can be used as an additional tool to support the work of healthcare professionals, providing further criteria for their decision making.
Alessandro Jatobá a, Hugo Cesar Bellas a, Mario Cesar R. Vidal b, Paulo Victor R. de Carvalho c
Open Access
Article
Conference Proceedings
Analysing the Differences of Resilience Between Experts and Novices in Order to Increase Medical Safety and Quality
In clinical sites, including hemodialysis, medical staff have to deal flexibly with fluctuations in the physical condition of patients or the progress of dialysis treatment in order to increase the safety and quality of medical services. It is often observed that experts can perform such actions, whereas novices cannot. A training program is needed to teach appropriate skills to novices in a short time. Therefore, it is necessary to clarify the components of experts’ behavior in order to develop such a training program. This study analyzed the differences between experts and novices in their performance during hemodialysis medical services. Subsequently, these differences were discussed from the viewpoint of resilience engineering. As a result, it was found that experts can anticipate the medical characteristics of patients and tasks (e.g., variability of each patient’s condition) and characteristics of patient satisfaction (e.g., contents of medical services that patients demand). Experts depend on their memories of previous treatments and apply them to today’s patient (even though the treatment conditions of the last time and today are different); however, this may lead to medical accidents.
Yoshitaka Maeda a, Satoshi Suzuki b, Akinori Komatsubara a
Open Access
Article
Conference Proceedings
Medical Factors of Brain Tumor Delineation in Radiotherapy for Software Design
In radiotherapy, the delineations of the volume of the macroscopic spread of the tumor as the Gross Tumor Volume (GTV), and the surrounding volume of the microscopic spread of the disease as the Clinical Target Volume (CTV), are key tasks for a high quality treatment plan. In order to design a software that also supports cognition, software designers need a deeper understanding of the physicians’ cognitive processes and medical context. This paper presents a research about identifying main medical factors relevant for the delineation in the radiotherapy context as a first step in deepening the understanding for software design. Using two discussion formats with six radiation oncologists, we identified 29 medical factors regarding the delineations of tumorous volumes, categorized into: treatment context, tumor context and tumorous areas. In addition, the role of multimodal images, dose planning, and future wishes have been elaborated. These findings could support the software designers in using Evidence Based Software Engineering approach. It is expected that software designed based on the results presented here, is tailored towards the medical context and cognitive needs of radiation oncologists in the delineations of brain tumor, and therefore will improve the effectiveness and efficiency of their work.
Anet Aselmaa, Richard H.M. Goossens, Ben Rowland, Anne Laprie, Yu Song, Adinda Freudenthal
Open Access
Article
Conference Proceedings
Exploring Macrocognitive Healthcare Work: Discovering Seeds for Design Guidelines for Clinical Decision Support
Modern healthcare can be described as a macrocognitive work system. In such systems, people seek to adapt to complexity through functions such as sensemaking, coordinating, and re-planning. Technologies can augment human cognitive abilities for managing attention, recalling information, projecting trajectories, and achieving common ground. The ideal healthcare system would integrate technologies in ways that maximize the ability of humans to adapt to complexity through coordinating and synchronizing activities, and help people anticipate surprise and error – while preserving the clinical experience among clinicians and patients. This paper reports on our effort to explore the macrocognitive work undertaken at a major healthcare network in the United States. Our team conducted 60 cognitive interviews across seven facilities, covering inpatient, outpatient and community-based settings. We report on our approach based in methods of Cognitive Task Analysis. The approach was simultaneously structured and adaptable, and was therefore well suited for exploratory data collection, as it permitted adjustments to the data collection strategy across a wide spectrum of performers, experience-levels, and work contexts. We review our data collection, analysis and representation methodology, and the seeds for design guidelines for clinical decision support that resulted from the effort.
Brian Moona, Robert Hoffmanb, Mary Lacroixc, Emory Fryc, Anne Millerd
Open Access
Article
Conference Proceedings
The Current State of Obesity in Healthcare: A Perfect Storm
Obesity is a growing public health problem in the United States. Obese individuals are at greater risk for early death as well as chronic diseases such as cancer, diabetes, cardiovascular disease, and musculoskeletal disorders. The economic costs related to obesity are substantial and are impacting society as a whole. More specifically they are having an impact on healthcare workers since obese individuals use healthcare services at a greater rate than normal weight individuals. The risk of injury to healthcare workers is also growing as this patient population increases. To date, much of the focus on injury risk to healthcare workers from obese patients has been in the area of patient handling at the bedside. However, there are other disciplines with increasing injury risks due to the growing needs of obese patients in surgery, OB/GYN, ultrasound, radiology, and even morgue/autopsy. It is difficult to control patient weights but more emphasis could be placed on maintaining healthy weights of healthcare workers. Previous research has demonstrated a relationship between workers BMI and injury rates. Thus the risks of working with obese patients coupled with growing obesity among healthcare workers is creating a “perfect storm” that can negatively impact the delivery of quality healthcare.
Tamara M. James
Open Access
Article
Conference Proceedings
The Evaluation of Compatibility between Human and Mattress using EMG
Sleeping environment can have a significant influence on sleep quality. Sleeping on the incorrect mattress can cause lot of health problems and affects comfort. The mattress with extra firmness or softness does not allow the sleepers muscle to rest. This study developed a methodology to evaluate compatibility between human and mattress firmness using an electromyogram (EMG). Two mattresses were considered (spring and tempur mattress) with different firmness. Ten healthy participants were tested (age: 31.70 ± 2.19 years; height: 170.90 ± 7.90 cm; weight: 70.60 ± 13.95 kg) on each mattress when lying supine and turning to their right for ten times. The EMG activities (RMS) were measured from eight different muscles (right side cervical paraspinal, right and left side upper trapezius, right and left side latissimus dorsi, right and left side lumbar erector spinae, and right side gastrocnemius lateral). Subjective rating was also collected from the participants. The RMS results showed significantly lower muscle activities when subject tossing and turning to their right on the spring mattress than tempur mattress. Spring mattress provided significantly greater relaxation on subjective rating. This methodology can be used to evaluate different mattress compatibility with various material properties.
Se Jin Park a, Seung Nam Min b, Murali Subramaniyam b, Heeran Lee a
Open Access
Article
Conference Proceedings
Patient Safety, Human Factors & Ergonomics, and Design: The Environment as a Larger-Scale Strategy to Reduce Falls
Falls are a key consideration for patient safety and play a prominent role under US legislation for affordable care. The built environment can either enhance safe practices and policy or act as an impediment for safe patient care. Falls are associated increased length of stay in hospitals and higher healthcare costs due to additional care, discharges to institutional care and litigation claims. With an increased focus on reimbursement related to patient safety as part of healthcare reform in the USA, organizations are becoming more aware of their own shortcomings and grappling with solutions to improve performance – typically people and processes. Yet the influence of the built environment, the space in which care is provided, can act as a barrier or enhancement to achieving the desired results – physically, cognitively, and organizationally. This paper presents the results from a mixed methods literature review on healthcare facility environmental design and falls. It is part of on-going research for the development of a Safety Risk Assessment (SRA) tool to promote discussion for proactive decision-making during the design of healthcare facility projects.
Ellen Taylor, Sue Hignett
Open Access
Article
Conference Proceedings
Ergonomic Interventions in WMSDs Prevention – A Case Study Using 3D Twist Insoles to Reduce the Body Pain in a Tape Manufacturing Company
Work-related musculoskeletal disorders (WMSDs) are becoming serious occupational safety and hygiene problem in Taiwan Industries. Overexertion, high repetition, prolonged exposure, cold and vibration are the five concerns as major WMSDs causes. The intrinsic factor, foot progression angle, should be further considered to reduce risk impact to the workers’ health. The purpose of this study is aimed to demonstrate the reduction of the workers’ body pain by ergonomic principles in a tape manufacturing company. The new developed 3D twist insoles with arch support are selected to help release pain. In this current study, workers with high arch and flat arch are selected as members of the study group, via a 2-step screening test to identify arch type and leg-axis. Nordic musculoskeletal questionnaires (NMQ) were further used to analyze musculoskeletal condition of the workers. Moreover, candidates with Body Mass Index (BMI) value higher than 25, age average over 42, and standing period over 8 hours each day are picked as study group using 3D twist heavy duty insoles. The control group has similar working situation in the same company, wearing the same type of safety boots without the insoles. After 20 weeks, the results suggest the study group of 14 workers have released 40% of pain.
Wen-Lian William Lee a b, Sai-Wei Yang c, Keh-Tao Liu d, Ingrid Yuan-Ying Lin d
Open Access
Article
Conference Proceedings
Measuring Mental Workload of Medical Physicists, Radiation Therapists and Dosimetrists at the Five Stages of Radiation Treatment Planning in External-Beam Radiotherapy using NASA-TLX
Mental Workload of Medical Physicists, Radiation Therapists and Dosimetrists was measured at five stages of Radiation Treatment Planning in External-Beam Radiation Therapy using NASA-TLX, a self-reported subjective technique for assessing mental workload developed by NASA (Hart and Staveland (1988). The five stages of the Treatment Planning process which were considered were; Image Import and Prescription Review, Target Contouring, Beam Manipulation and Calculation, Physician Approval, and Export of Plan to Pre-Treatment Review. Besides the assessed workload, the discrepancies and deviations from protocol (defined here as errors) reported during the five stages of the Treatment Planning process were also recorded using two independent internal reporting systems. The work was carried out over a two week period during September and October 2013 and 21 treatment cases were assessed in total. Medium to high perceived mental workload was reported in all five stages of the Treatment Planning process. Nine cases of errors were rectified and recorded in 7 out of the 21 treatments. The workload and error values recorded are discussed, as well as the association between errors and mental workload.
Matjaž Galičiča, Enda F. Fallona, Wil van der Puttenab, Gordon Sandsa, Margaret Mooreb
Open Access
Article
Conference Proceedings
A New Model for Successful Safe Patient Handling Programs
The transport, transfer, adjustment, and general handling of hospital patients accounts for one of the most significant injury risks for healthcare workers. This is true for the general population of patients and even more so for bariatric patients. Safe Patient Handling Programs are increasingly becoming the norm for hospitals and long term care facilities. The use of lifting, transferring, and mobilizing equipment is mandated in many states in order to protect both the healthcare workers and the patients from injury due to manual lifting.The experience with such programs for many healthcare facilities presents a cautionary tale of great promise of benefit and very difficult delivery of same. This is a major culture change for nurses and other healthcare employees. The scenario goes something like this: Everyone (or nearly everyone) is delighted with the idea and seems eager to move forward with it. Equipment is purchased and everyone is trained to some extent on how to use it. The news of the program is presented to the public with ribbon cutting or similar fanfare. Soon thereafter it becomes clear that there were several things that were not considered such as laundry for the slings, who repairs the lifts, where IS the lift, where are the repo sheets. These oversights are soon followed by, “it takes too long”, “this isn’t working”, “I liked the old way”, and so on.Preventing this decline in the program requires dedicated “champions”. They must be able to assist other personnel with patient handling tasks, have a thorough working knowledge of all the lift equipment, and can provide the training or retraining so necessary as care givers encounter issues that were not covered in the first round of training. At Stanford Hospital and Clinics and Lucile Packard Children’s Hospital we’re moving to the “lift coach” model to provide these things. This presentation describes the model and offers data on our experience over the past year. We believe this to be the best and most workable solution for culture change and successful Safe Patient Handling Program implementation. The presentation includes a unique Return On Investment calculation that we believe will be of great interest.
a John Vaughan, Jeffery Driver, Edward Hall, bEric Race
Open Access
Article
Conference Proceedings
Assessing Medicine Labels to Improve Usability
The information on how and when to take a prescribed medicine is provided to the patient by the doctor. Although different countries, even states may have different standards and regulations, it is a necessity for almost each drug to include medication labels. Medication labels refer to, Container Label, Consumer Medication Information (CMI), Package Insert, and Medication Guide. The labels are prepared based on health literacy and aim to improve patient safety. If people cannot understand the health information they need or receive inadequate/inaccurate knowledge of disease and treatment, this may cause serious problems. Therefore, to avoid costly urgent services and adverse effects; medication labels must be design for potential users. This study investigates how information is presented in several medical labels. To improve usability, factors to be considered are defined and assessed by a survey. A case study is provided to compare the current printed package insert and the redesigned one.
Berna Ulutas, Firat Ozkan
Open Access
Article
Conference Proceedings
A Patient-Centered Design Approach to Facility Planning
Due to the physical, mental and social tolls diagnosis and treatment imparts, patients undergoing cancer care find the experience incredibly taxing. Treatments range in duration from weeks to months, and involve lab tests, possibly surgery, infusions and recovery time. A medical center in the Veterans Affairs healthcare system wanted to both relocate and redesign their Hematology/Oncology clinic and infusion suite to better accommodate the needs of their patients during the difficult treatment phase. Stakeholders had three guiding questions for the redesign team to address: what are the state-of-the-art concepts in patient-centered cancer care facilities, which of those concepts should the medical center incorporate, and what trade-offs are associated with design alternatives? The process of Preparation – Incubation – Illumination – Verification was used to develop a concept design for a care delivery system and an associated floor plan. This process involved stakeholder meetings, collaborative rapid paper prototyping sessions, site visits to other facilities, and simulation of suggested traffic flows and floor plans. Design highlights include patient-centric features such as hoteling of exam rooms and infusion bays with windows to the outside. It incorporates the idea of critical adjacencies by locating cancer care services in the same area. Since moving the lab was not possible, exchanging lab materials are facilitated by a pneumatic tube system. Finally, patients are able to choose the level of privacy they desire, with three types of infusion bays available. This process demonstrated the value of a rigorous and comprehensive approach to facility design, taking into consideration patient comfort and treatment efficiency.
Nancy J. Lightnera, Andrew Carlstromb, Christopher Hughesb
Open Access
Article
Conference Proceedings
Design of Wearable Product for Protecting Pelvis from Falls
The aim of this study is to design a wearable product for protecting pelvis from falls. In this product, an airbag cushion system was applied to absorb falling impact energy from falls. Korea became an ‘ageing society’ (defined as a society of more than 7% of elderly population) in 2000 and is expected to be going into an 'aged society' (more than 14% of elderly population) in 2018 and a 'super aged' (more than 20% of elderly population) in 2026. Falls can be occurred in all life-cycle. In particular old people over 65 years have more experiences of falls. The elderly have various forms of physical and mental degeneration and so they can easily meet a fall by tripping over a stone, slipping, etc. In fact, fall and slip account for 55.3 percent of all accidents in case of the elderly in Korea. Therefore, it is necessary to develop a product to prevent the elderly's injury from falls. Wearable airbag cushion system will be developed in this study and firstly its design was developed. The characteristics of elderly falls were identified from some previous studies and design requirements considering the characteristics were proposed. Finally, the design of pelvic airbag cushion system for absorbing falling impact energy was developed.
Kwang Tae Junga, Sung Min Kim a, Keyoung Jin Chunb, Jae Soo Hongb
Open Access
Article
Conference Proceedings
Ergonomic Analysis of Dental Equipment
This study proposes to evaluate the ergonomic aspects of dental equipments. Based on the requirements proposed by ISO/FDI, on the existing literature and related researches an evaluating system was devised. Thirty nine dental clinics were examined using 165 points-system proposed, distributed in 12 criteria. None of the dental clinics examined showed a bad ergonomics level, 41% were good and 59% reached excellent levels. The point-supported evaluation system proposed is effective in the analysis of the ergonomic conditions of dental equipments, allowing a quantification of their characteristics. Using this system, the dentist can also know the level of ergonomic satisfaction existing in his equipment, and indentify the conditions to be improved. It was concluded that the equipment belonging to dental workplaces evaluated had excellent level of compliance, however corrective measures are needed since even the presence of a few non-conforming items is a sufficient condition to cause injury to users, decreased efficiency and comfort and loss quality of service.
Eliel Soares Orenha a, Wilson Galvão Naressi a, Suely Carvalho Mutti Naressi a, Symone Cristina Teixeira a, Enzo Rosetti a, Natalia Miguel a, Angélica Cristiane Bulio Soares b
Open Access
Article
Conference Proceedings