Work - Volume 41, issue Supplement 1

Authors: Ribeiro, Sânzia Bezerra | Cárdia, Maria Claudia Gatto | Almeida, Lais Cristina

Article Type: Research Article

Abstract: The objective present study was to investigate the presence of low back pain in caregivers of a nursing home, related with the labored activities executed by these workers. 16 subjects were investigated, 15 female and one male, with 40,8 age average all being caregivers as their profession. It consisted of three phases, where the first concerns the analysis of the collective work, assessed in a perspective of caregivers, Second, a postural assessment to verify the retractions in such workers and the third stage was used Diagram of Corllet to identify the presence of signs and symptoms in caregivers. The study …demonstrated that organizational and biomechanical factors are responsible for the high level of physical fatigue and presence of pain in 93,75% of the caregivers in some region of the body. 50% referred pain in the lumbar region. The results of the postural evaluation confirmed that the caregivers had alterations in the postural alignment, presenting retractions of the anterior and posterior chain. The suggestions are to minimize the risk factors of this productive process and the symptoms and signals presented from these workers by adoption ergonomic measures and the realization of a physical program with stretching and muscular strengthening of the muscles of thee anterior and posterior body chain based on the method of Reorganization Postural Sensoperceptive . Show more

Keywords: low back pain, caregivers, enderly, overload work

DOI: 10.3233/WOR-2012-0410-1933

Citation: Work, vol. 41, no. Supplement 1, pp. 1933-1939, 2012

Authors: Hermanson, James E. | Choi, Sang D.

Article Type: Research Article

Abstract: Due to the cost and time benefits associated with patients and physicians, outpatient surgeries continue to become more and more popular over time. With the increase in the number of office-based surgical procedures, the prevalence of work-related musculoskeletal disorders (WMSDs) associated with office-based surgeries has been reported. The purpose of this pilot study is to ergonomically evaluate the risk of work-related musculoskeletal disorders of physicians/surgeons performing office-based surgery (OBS). Ergonomic assessment tools included Questionnaire, the BodyMap and the Rapid Upper Limb Assessment for measuring potential ergonomic concerns. The findings have shown that the ergonomic issues of greatest concerns were the …discomforts in the neck, shoulders, arms/wrists, and back. Some additional comments were provided by the participants regarding the duration of discomfort or clarification on the frequency of their body discomfort. This study suggests that there is a considerable risk of musculoskeletal injuries of physicians/surgeons performing the OBS tasks. By properly using the ergonomic assessment techniques, valuable information on ergonomic OBS workplace design and selection could assist in the early interventions of WMSD prevention. Show more

Keywords: ergonomic assessment, body discomfort, work posture, musculoskeletal disorders, healthcare

DOI: 10.3233/WOR-2012-0411-1940

Citation: Work, vol. 41, no. Supplement 1, pp. 1940-1943, 2012

Authors: Yu, Denny | Sackllah, Michael | Woolley, Charles | Kasten, Steven | Armstrong, Thomas

Article Type: Research Article

Abstract: The purpose of this paper is to present a quantitative posture analysis of microsurgery tasks performed with different visualization methods. Microsurgery is traditionally performed using a binocular microscope; however surgeons are constrained by the optical eyepieces and are forced to assume joint angles that deviate away from neutral postures. This may be especially problematic for the neck and can increase surgeon discomfort and fatigue. Alternative visualization methods may improve surgeon posture by eliminating the constraints imposed by the microscope. This study examines both 2D and 3D heads-up displays as possible alternatives. Six subjects performed microsurgical tasks with each visualization methods …for four hours. Quantitative posture analysis was done using Maxtraq software that tracks reflective markers on the subjects. The initial analysis of neck, upper arm, and elbow angles found significant differences between each display. A biomechanical analysis found that the differences in angles can result in loads on the neck joint that are twice as high in the microscope than the headsup displays. Although the alternative displays can result in better postures, improvements the display technology is needed to improve microsurgical task performance. Show more

Keywords: microscope, heads-up display, posture analysis, surgery

DOI: 10.3233/WOR-2012-0412-1944

Citation: Work, vol. 41, no. Supplement 1, pp. 1944-1947, 2012

Authors: Samaras, George M.

Article Type: Research Article

Abstract: Healthcare information technology (HIT) is being offered as a transformer of modern healthcare delivery systems. Some believe that it has the potential to improve patient safety, increase the effectiveness of healthcare delivery, and generate significant cost savings. In other industrial sectors, information technology has dramatically influenced quality and profitability – sometimes for the better and sometimes not. Quality improvement efforts in healthcare delivery have not yet produced the dramatic results obtained in other industrial sectors. This may be that previously successful quality improvement experts do not possess the requisite domain knowledge (clinical experience and expertise). It also appears related to …a continuing misconception regarding the origins and meaning of work errors in healthcare delivery. The focus here is on system use errors rather than individual user errors. System use errors originate in both the development and the deployment of technology. Not recognizing stakeholders and their conflicting needs, wants, and desires (NWDs) may lead to stakeholder dissonance. Mistakes translating stakeholder NWDs into development or deployment requirements may lead to latent errors. Mistakes translating requirements into specifications may lead to drift errors. At the sharp end, workers encounter system use errors or, recognizing the risk, expend extensive and unanticipated resources to avoid them. Show more

Keywords: human factors, healthcare, technology, quality, improvement

DOI: 10.3233/WOR-2012-0413-1948

Citation: Work, vol. 41, no. Supplement 1, pp. 1948-1955, 2012

Authors: Nascimento, Adelaide | Falzon, Pierre

Article Type: Research Article

Abstract: The purpose of this article is to understand the way in which medical physicists take into account treatment effectiveness and safety when selecting a treatment plan, with respect to the medical prescription and the technical, human and organizational resources available. Data-gathering was based on the allo-confrontation method: 14 medical physicists from five different treatment centers commented on real treatment plans that had been drawn up by their colleagues. Results show that medical physicists have two means at their disposal to control treatment effectiveness and safety: risk avoidance and risk reduction. Risk avoidance is achieved when conceiving the solution. Risk reduction …occurs after the design of the plan and consists in accompanying and assisting the radiographers at the work station where the treatment is carried out. Show more

Keywords: safety, effectiveness, quality, radiotherapy

DOI: 10.3233/WOR-2012-0414-1956

Citation: Work, vol. 41, no. Supplement 1, pp. 1956-1960, 2012

Authors: Smith, Thomas J.

Article Type: Research Article

Abstract: This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children’s hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of …selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. Conclusions: (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues. Show more

Keywords: intensive care, private room design, occupancy quality

DOI: 10.3233/WOR-2012-0415-1961

Citation: Work, vol. 41, no. Supplement 1, pp. 1961-1968, 2012

Authors: Van der Molen, Henk F. | Zwinderman, Koos AH | Sluiter, Judith K. | Frings-Dresen, Monique H.W.

Article Type: Research Article

Abstract: Needle stick injuries (NSIs) are frequently reported as occupational injuries among health care workers. The health effects of a NSI can be significant when blood-to-blood contact occurs from patient to health care worker. The objective of this study was to evaluate whether the number of NSIs decreased among health care workers at risk in one Dutch academic hospital after introduction of injection needles with safety devices in combination with an interactive workshop. In a cluster threearmed randomized controlled trial, 23 hospital divisions (n=796 health care workers) were randomly assigned to a group that was subjected to the use of a …‘safety device plus workshop’, to a group that was subjected to a ‘workshop only’ or to a control group with no intervention. The combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention. For practice, the use of relatively simple protective needle safety devices and interactive communication are effective measures for reducing NSI’s. Show more

Keywords: needle stick injuries, prevention, health care

DOI: 10.3233/WOR-2012-0416-1969

Citation: Work, vol. 41, no. Supplement 1, pp. 1969-1971, 2012

Authors: Cuvelier, L. | Falzon, P. | Granry, J.C. | Moll, M.C.

Article Type: Research Article

Abstract: This study aims to describe how anesthesia teams handle unforeseen events that may affect the patients’ health. More precisely, it investigates the mechanisms of decisions made by anesthesia teams to manage unthought-of situations, i.e. situations that have not been foreseen as “possible” ones before their occurrence. An empirical study, based on the analysis of simulated situations, was conducted in a pediatric anesthesia service of a university hospital in France. The results highlighted three ways of managing unthought-of situations (determined management, cautious management and overwhelmed management). They support the hypothesis of a collective cognitive trade-off, whereby teams would behave as virtual …operators, with their own collective trade-off between "understanding" and "doing". The discussion of the results questions the assessment criteria, the safety perspectives we adopt and the possible ways to improve the management of unforeseen situations. Show more

Keywords: patient safety, adaptive safety, simulation, team work, unexpectedness

DOI: 10.3233/WOR-2012-0417-1972

Citation: Work, vol. 41, no. Supplement 1, pp. 1972-1979, 2012

Authors: Moody, Louise | Woodcock, Andree | Heelis, Mike | Chichi, Cynthia | Fielden, Simon | Stefanov, Dimitar

Article Type: Research Article

Abstract: Wheelchair users experience many situations that affect the stability and associated performance of their wheelchair. Stability is affected by user characteristics and abilities, environmental features and conditions, and wheelchair modification and accessories. Wheelchair prescribers need effective tools and methods to provide quantitative evaluation and prediction of the behavior of the user-wheelchair system in a variety of static and dynamic situations. Such information is very important to guide efficient management of associated risks and adjust chairs accordingly. This project involves a user-centered approach for design and evaluation of a load cell based wheelchair stability assessment system (Wheel-SAS). Here, the current methods …for assessing stability are described, and their shortcomings explained. The user-centered design approach being applied to the development of the associated Wheel-SAS hardware and software is described. Future work including semi-structured interviews and an online survey with wheelchair prescribers and associated healthcare professionals for deriving user requirements and a design specification for a load cell system for measuring dynamic wheelchair stability are detailed. Show more

Keywords: wheelchair stability assessment, wheelchair prescription, Wheel-SAS

DOI: 10.3233/WOR-2012-0418-1980

Citation: Work, vol. 41, no. Supplement 1, pp. 1980-1984, 2012

Authors: Willemen, Tim | Van Deun, Dorien | Verhaert, Vincent | Pirrera, Sandra | Exadaktylos, Vasileios | Verbraecken, Johan | Haex, Bart | Sloten, Jos Vander

Article Type: Research Article

Abstract: Ergonomic sleep studies benefit from long-term monitoring in the home environment to cope with daily variations and habituation effects. Polysomnography allows to asses sleep accurately, but is costly, time-consuming and possibly disturbing for the sleeper. Actigraphy is cheap and user friendly, but for many studies lacks accuracy and detailed information. This proof-of-concept study investigates Least-Squares Support Vector Machines as a tool for automatic sleep stage classification (Wake-N1-Rem to N2-N3 separation), using automatic trainingset-specific filtered features as derived from three easy to register signals, namely heart rate, breathing rate and movement. The algorithms are trained and validated using 20 nights out …of a 600 night database from over 100 different healthy persons. Different training and test set strategies were analyzed leading to different results. The more person-specific the training nights to the test nights, the better the classification accuracy as validated against the hypnograms scored by experts from the full polysomnograms. In the limit of complete person-specific training, the accuracy of the algorithm on the test set reached 94%. This means that this algorithm could serve its use in long-term monitoring sleep studies in the home environment, especially when prior person-specific polysomnographic training is performed. Show more

Keywords: LS-SVM, actigraphy, polysomnography

DOI: 10.3233/WOR-2012-0419-1985

Citation: Work, vol. 41, no. Supplement 1, pp. 1985-1989, 2012