Care Equipment Research Articles

Developing and Evaluating a Novel Educational Intensive Care Unit Wall Map

Developing and Evaluating a Novel Educational Intensive Care Unit Wall Map

Risk Factors and Outcome Analysis of Gram-Positive Bacteremia in Critically Ill Patients.

Introduction Bloodstream infection (BSI) is a common problem for patients in the intensive care unit (ICU). Nearly 60% of primary bloodstream infections are caused by Gram-positive cocci. Gram-positive bacteria gain access to the bloodstream through invasive procedures and various patient care equipment like catheters, intravenous lines, and mechanical ventilators.S. aureus is considered to be the major cause of septicemia. Knowledge of healthcare-associated infections and the antimicrobial susceptibility patterns of the isolates are crucial in guiding empirical treatment. Methods This prospective observational study was conducted in Medical ICU, Dayanand Medical College & Hospital, Ludhiana over a period of one year (December 2015 to November 2016). Patients whose blood cultures tested positive for Gram-positive bacteria were included in the study. This study was carried out to assess the implications and risk factors for nosocomial BSI and several factors, including the age of the patient, the severity of illness, the presence of catheters, and the microorganisms causing the BSI to independently predict mortality. Chief complaints and risk factors were evaluated. APACHE-II scores were calculated for all patients and outcomes were analyzed. Results In our study, the mean age of patients was 50.93±14.09 years. Central line insertion was found as the most common risk factor (58.7%). A statistically significant correlation was obtained between APACHE-II scores and the presence of risk factors i.e. central line insertion (p-value=0.010) and diabetes mellitus (p-value=0.003). The most common Gram-positive pathogen isolated by blood culture was methicillin-sensitive S. aureus (44.2%). For management, the majority of the patients were prescribed teicoplanin (58.7%). The 28-dayoverall mortality rate in our study was 52.9%. Conclusion We conclude that independent risk factors like diabetes mellitus, central line insertion, and acute pancreatitis in adult patients with Gram-positive bacteremia were associated with higher mortality. We have also concluded that the administration of early appropriate antibiotics improves patient outcomes.

Essential equipment and services for otolaryngology care: a proposal by the Global Otolaryngology-Head and Neck Surgery Initiative.

To highlight the need for comprehensive resource lists to provide baseline care of otolaryngologic conditions; to present a proposed list of essential equipment and services that may be applied toward surgical systems research, policymaking, and charitable efforts in global otolaryngology-head and neck surgery. To provide effective and high-quality surgical care across care settings, there must be a global standard for equipment and ancillary services necessary to provide baseline care. Though there have been efforts to devise resource standards via equipment lists and appraisal tools, these have been limited in scope to general surgery, emergency care, and a few other subspecialty surgical contexts. Recent efforts have brought attention to the significant burden imposed by otolaryngologic conditions such as hearing loss, otitis media, head and neck cancer, head and neck trauma, and upper airway foreign bodies. Yet, there has not been a comprehensive list of resources necessary to provide baseline care for common otolaryngologic conditions. Through an internal survey of its members, the Global Otolaryngology-Head and Neck Surgery Initiative has compiled a list of essential equipment and services to provide baseline care of otolaryngologic conditions. Our efforts aimed to address common otolaryngologic conditions that have been previously identified as high-priority with respect to prevalence and burden of disease. This expert-driven list of essential resources functions as an initial framework to be adapted for internal quality assessment, implementation research, health policy development, and economic priority-setting.

Prototype of a Baby Incubator Physical Parameter Measurement Tool: Temperature, Humidity, Airflow and Noise Level

The Incubator Analyzer is equipment to measure the physical parameters contained in the baby incubator to verify the output value of the device and ensure the safety of the equipment for patient care. Currently, there are several products of baby incubator analyzer in Indonesia, but the availability of goods is still imported with relatively expensive product prices, so in this article, we report the development of a prototype baby incubator physical parameter measurement equipment to support the domestic product independence program. The method that has been carried out in this research is experimental in designing and developing a baby incubator physical parameter by maximizing the availability of components in the local market. Design of the prototype refers to SNI IEC 60601-2-19-2014 which is a standard of special requirements for basic safety and essential performance of infant incubators, with the measured parameters consisting of measurements of air temperature in the incubator room, mattress temperature, humidity, airflow, and noise level. The temperature measurement design uses a resistive temperature detector PT 100, SHT 11 as a humidity sensor, GFS131 as an airflow sensor, MAX4466 as a microphone amplifier as a sound sensor, and a 3.5” nextion TFT LCD as a display. This prototype is also equipped with a rechargeable battery system as a portable power supply. The testing is carried out by comparing the results read by a device designed with the Incu Analyzer II Fluke Biomedical. The results show that the prototype of the baby incubator parameter measuring instrument is able to read the values of temperature, humidity, airflow, and noise level in the baby incubator chamber. The accuracy of temperature parameter measurement reaches more than 98%, so this prototype has the potential to be tested by authorized institutions.

COVID-19 infection in nursing staff: A cohort study.

This study aims to identify the working conditions of Brazilian nursing professionals and the risk factors for these professionals to become infected by coronavirus disease. Understanding the factors that affected nursing professionals during the pandemic can support better nursing management. This is a quantitative, cross-sectional survey study. Data collection was carried out between February and March 2022 in Brazil. All nursing professionals registered in the national database received by e-mail the study instrument with the data collection variables: professionals' sociodemographic and comorbid, professional and institutional characteristics, and professionals' health conditions and disease-related aspects for COVID-19. Four thousand eight hundred sixty-two nursing professionals reported a lack of personal protective equipment for patient care, and 4424 were infected by coronavirus disease. The risk factors to become infected were having cardiovascular disease, being under 60 years of age, living in the northern region, using public transportation, working in a hospital, an emergency department or reference institution for COVID-19, living with an infected person and lack of respirators or waterproof aprons. Multiple risk factors for infection with SARS-CoV-2 were demonstrated for the nursing professionals during the pandemic, highlighting current and future pandemics factors that are modifiable in a worthwhile time frame to minimize nurses' infection risks, such as inadequate working conditions associated with lack of essential personal protective equipment.

Simulation, Analysis, and Experimentation of the Compliant Finger as a Part of Hand-Compliant Mechanism Development

Compliant mechanisms are gaining popularity in many different fields, such as in microelectromechanical systems (MEMS), medical applications and health care, opto-mechatronic technology, aerospace engineering, and semiconductor equipment. One of the areas for utilizing compliant mechanisms is building models of human hand counterparts. These models are often used as grasping and rehabilitation devices. Because of their properties, creating a human hand counterpart with compliant mechanisms is a much better choice compared with the models with traditional mechanisms; it looks more realistic, and its movements are much more natural compared with models with a traditional mechanism. A method of modeling and designing such a bio-inspired mechanism, as well as its experimental analysis with various forces applied, is presented in this paper. Two prototypes of the compliant fingers were obtained by 3D printing, and the calculation of the bending angle values was achieved by applying image processing to camera images of the compliant fingers’ prototypes. Image processing was conducted on images taken for both loaded and unloaded 3D-printed compliant finger prototype positions. Finally, these bending angle results are compared with the results obtained by Finite Element Method (FEM) analysis and experimental results acquired by a digital protractor.

United States Consumers’ Landscaping Expenditures: A Case of Garden and Lawn Care Services and Equipment

The economic downturns of 2007–09 and the COVID-19 pandemic affected most industries in the United States, including landscape services and equipment sales, and provoked both short-term disruptions and long-term changes. To understand how the landscaping industry has responded, we investigated patterns of consumer expenditures on landscape services and equipment from 2009 through 2021 using a representative sample of 76,895 US households. We categorized US households as detached single-family residents and townhouse residents to more fully articulate the factors that turned potential consumers into purchasers and the factors that affected purchasers’ expenditures. We used a double-hurdle model to identify key factors that drive consumer demand for landscape services and equipment over time, including social-demographics, geographic characteristics, housing conditions, year and seasonal trends, and the COVID-19 pandemic. We found that during the studied period, the demand for landscape services declined in terms of both the percentage of consumers purchasing the services and the purchasers’ average expenditures, while the demand for do-it-yourself (DIY) equipment remained relatively unchanged. In response to the COVID-19 pandemic, the percentage of consumers who purchased landscape services increased, while the expenditures on landscape services decreased in 2020 and then began to rebound in 2021, but not enough to reverse the overall downward trend. In contrast, purchases of DIY equipment were relatively stable in response to the COVID-19 pandemic and mainly relied on current consumers.

Antibiotic Prescribing in Outpatient Settings: Rural Patients Are More Likely to Receive Fluoroquinolones and Longer Antibiotic Courses.

Suboptimal antibiotic prescribing may be more common in patients living in rural versus urban areas due to various factors such as decreased access to care and diagnostic testing equipment. Prior work demonstrated a rural health disparity of overprescribing antibiotics and longer durations of antibiotic therapy in the United States; however, large-scale evaluations are limited. We evaluated the association of rural residence with suboptimal outpatient antibiotic use in the national Veterans Affairs (VA) system. Outpatient antibiotic dispensing was assessed for the veterans diagnosed with an upper respiratory tract infection (URI), pneumonia (PNA), urinary tract infection (UTI), or skin and soft tissue infection (SSTI) in 2010-2020. Rural-urban status was determined using rural-urban commuting area codes. Suboptimal antibiotic use was defined as (1) outpatient fluoroquinolone dispensing and (2) longer antibiotic courses (>ten days). Geographic variation in suboptimal antibiotic use was mapped. Time trends in suboptimal antibiotic use were assessed with Joinpoint regression. While controlling for confounding, the association of rurality and suboptimal antibiotic use was assessed with generalized linear mixed models with a binary distribution and logit link, accounting for clustering by region and year. Of the 1,405,642 veterans diagnosed with a URI, PNA, UTI, or SSTI and dispensed an outpatient antibiotic, 22.8% were rural-residing. In 2010-2020, in the rural- and urban-residing veterans, the proportion of dispensed fluoroquinolones declined by 9.9% and 10.6% per year, respectively. The rural-residing veterans were more likely to be prescribed fluoroquinolones (19.0% vs. 17.5%; adjusted odds ratio (aOR), 1.03; 95% confidence interval (CI), 1.02-1.04) and longer antibiotic courses (53.8% vs. 48.5%; aOR, 1.19, 95% CI, 1.18-1.20) than the urban-residing veterans. Among a large national cohort of veterans diagnosed with URIs, PNA, UTIs, and SSTIs, fluoroquinolone use and longer antibiotic courses were disproportionally more common among rural- as compared to urban-residing veterans. Outpatient antibiotic prescribing must be improved, particularly for rural-residing patients. There are many possible solutions, of which antibiotic stewardship interventions are but one.

Postnatal care services in rural Zambia: a qualitative exploration of user, provider, and community perspectives on quality of care

BackgroundPostnatal care (PNC) is an important set of services offered to the mother and her newborn baby immediately after birth for the first six weeks to prevent maternal and neonatal complications and death. This qualitative study explored user and provider perspectives on quality of PNC services in the selected health facilities within the context of the Maternity Homes Access in Zambia project in the Saving Mothers Giving Life districts in rural Zambia.MethodsBetween October 2018 and February 2019, forty focus group discussions (FGDs) (n = 160 participants) and twelve in-depth interviews (IDIs) were conducted in four districts in Southern and Eastern provinces. FGDs comprised women who delivered within the last year, fathers, community elders, and volunteers. IDIs comprised health workers at facility, district, and provincial levels. Data were analysed using content analysis guided by the international quality of care domains derived from the World Health Organization quality of care framework. Findings were triangulated to understand perceptions.ResultsOverall, study participants perceived PNC services to be beneficial. Nevertheless, respondents had mixed feelings on the quality of PNC services and expressed a stark difference in their perception of factors affecting service quality. Service users described challenges arising from ineffective communication about the new PNC guidelines, and non-adherence of service providers to quality standards regarding respect, preservation of dignity and emotional support. Other factors were long waiting hours, small examination rooms providing inadequate privacy, and low levels of confidentiality. In contrast, service providers attributed poor service quality to various health system-related factors including low staffing levels, dysfunctional referral services, low supply of essential medicines, supplies, vaccines and equipment for optimal routine emergency obstetric and newborn care and management of complications.ConclusionThese findings highlight important intervention opportunities to improve quality of PNC services in Zambia through better communication and raising awareness on PNC guidelines, respect, preservation of dignity and emotional support to mothers. Interventions should also focus on addressing contextual health system challenges including staffing levels, supply chain for essential medicines and commodities, shortening waiting time, and ensuring functional referral system.

Emergency Care Capacity in Pediatric Hospitals, Khartoum, Sudan

Introduction: Critical pediatric patients have specific needs, which require special skills, training, equipment, supplies, personnel, and medications. While the knowledge related to enhance survival rate of newborn and children has improved over the past few decades. This study conducted to assess the emergency care capacity in pediatric hospitals at Khartoum state, Sudan. Methods: This is a descriptive cross-sectional hospital-based study, it was conducted in three hospitals at Khartoum, Sudan 2017-2018, to assess emergency care capacity in pediatric hospitals. Data was collected using open-ended questionnaire, and observational checklist. The data scored using dichotomous indicators (absent or present). Results: The study showed that there is shortage in human resources necessary to provide emergency care. However, much essential equipment for emergency care of children was absent in most hospitals, moreover, only 33% of hospitals had Triage system staffed by a trained person. Further, the clinical practice protocols for managing dehydration, neonatal sepsis, and neonatal resuscitation were not traced at the three hospitals. There are a limited laboratory services in one hospital. Conclusion: It is concluded that pediatric specialized hospitals, in Khartoum state, Sudan, have low capacity to provide emergency care for children. Further efforts are needed to improve the emergency care capacity in Khartoum hospitals.

Advances in pre-hospital emergency care

Background: Emergency Medical Services (EMS) in the United States have evolved significantly since the 1960s, leading to a complex and diverse system that varies across regions. Despite the critical role EMS plays in pre-hospital care, there remains substantial confusion about its operations, structure, and effectiveness. This complexity has driven the need for innovative practices and technology to enhance pre-hospital care and patient outcomes. Aim: This article reviews recent advancements in pre-hospital emergency care, focusing on innovations and technological developments designed to improve EMS efficiency and patient outcomes. Methods: A comprehensive review of literature and current practices in pre-hospital care was conducted, examining advancements in technology, EMS curricula, and the integration of new tools and techniques into emergency medical practices. Results: Key innovations in pre-hospital care include mobile health technology, telemedicine integration, advanced diagnostic devices, automated external defibrillators (AEDs), wearable health sensors, drones for medical delivery, enhanced trauma care equipment, electronic patient care reporting (ePCR), portable ventilators, and simulation training. These advancements have improved real-time data collection, patient monitoring, diagnostic accuracy, and overall efficiency of emergency responses. Conclusion: The integration of innovative technologies and practices into EMS has substantially enhanced pre-hospital care.

Sterilization techniques of anesthetic and critical care equipment – A review

Disinfection and sterilization are important and core steps in healthcare system. The infection control is not only for the benefit of the patient but presently it is a medico legally held responsible. One should have adequate knowledge about the sterilization of equipment. Although various disposable single use materials are present in healthcare system it will not be a cost effective method especially for the developing and underdeveloped countries. Inadequate knowledge will lead to hospital acquired infections and may also lead to life threatening cross infections. A proper infection control team and multidisciplinary approach will help to counter the infections in a scientific and cost effective way. This article describes various methods used for sterilization and also describes various commonly used equipment and their sterilization techniques.

Reshaping healthcare supply chain using chain-of-things technology and key lessons experienced from COVID-19 pandemic

The COVID-19 (Corona virus disease 2019) pandemic continues to slash through the entire humanity on the earth causing an international health crisis and financial uncertainty. The pandemic has formed a colossal disruption in supply chain networks. It has caused piling higher mortality in patients with comorbidities and generated a surging demand for critical care equipment, vaccines, pharmaceuticals, and cutting-edge technologies. Personal protective equipment, masks, ventilators, testing kits, and even commodities required for daily care have been scarce as lockdown and social distancing guidelines have kicked in. Amidst COVID-19, implementing and executing key processes of the healthcare supply chain (HSC) in a secured, trusted, effective, universally manageable, and the traceable way is perplexing owing to the fragile nature of the HSC, which is susceptible to redundant efforts and systemic risks that can lead to adverse impacts on consumer health and safety. Though the crisis shone a harsh light on the cracks and weaknesses of the HSC, it brings some significant insights into how HSC can be made more resilient and how healthcare industries figure out solutions to mitigate disruptions. While there are innumerable experiences learned from the disruption of this crisis, in this paper, five important areas to analyze the most vital and immediate HSC enhancements including building a resilient supply chain, thinking localization, implementing reliable reverse logistics, breaking down extant silos to achieve end-to-end visibility, and redesigning HSC using digitalization are emphasized. This work identifies important features related to CoT and HSC. Also, this study links these lessons to a potential solution through Chain of Things (CoT) technology. CoT technology provides a better way to monitor HSC products by integrating the Internet of Things (IoT) with blockchain networks. However, such an integrated solution should not only focus on the required features and aspects but also on the correlation among different features. The major objective of this study is to reveal the influence path of CoT on smart HSC development. Hence, this study exploits (i) fuzzy set theory to eliminate redundant and unrelated features; (ii) the Decision-Making and Experimental Evaluation Laboratory (DEMATEL) method to handle the intricate correlation among different features. This fuzzy-DEMATEL (F-DEMATEL) model attempts to direct CoT technology towards smart HSC by identifying the most influencing factors and investors are recommended to contribute to the development of application systems. This work also demonstrates how CoT can act a vital role in handling the HSC issues triggered by the pandemic now and in the post-COVID-19 world. Also, this work proposes different CoT design patterns for increasing opportunities in the HSC network and applied them as imperative solutions for major challenges related to traditional HSC networks.

Assistive technology in palliative medicine: equipment needs

ObjectivesMost people prefer to die at home. Timely and appropriate provision of assistive technology can support people to remain at home in the palliative phase. A state-wide palliative care equipment...

Experimental Assessment of an Air Curtain-Sealed Personal Protective Equipment for Medical Care: Influence of Breathing and Thermal Plume

Experimental Assessment of an Air Curtain-Sealed Personal Protective Equipment for Medical Care: Influence of Breathing and Thermal Plume

Engelli kadınlarda üreme sağlığını etkileyen etmenler, üreme sağlığı sorunları ve hemşirenin rolü

Factors affecting reproductive health in women with disabilities, reproductive health problems and the role of the nurse Approximately15% of the world’s population lives with a physical, sensory, intellectual or mental disability, and 80% of these disabled individuals are in low– and middle-income countries. Women with disabilities are the group with the greatest difficulty in accessing and using information and services related to their sexual and reproductive health rights, which are the right of everyone around the world. The vast majority of women with disabilities do not have a say in sexual and reproductive health, they are accepted as genderless, they are evaluated as if they do not have reproductive rights, and they face obstacles. Factors such as people’s perceptions of disability, inaccessible health care facilities and equipment, discrimination, transportation barriers to accessing facilities, economic inadequacy, negative treatment from staff, unequal allocation of time and money within the household for their care prevent women from seeking, using and accessing health care. The barriers faced by women with disabilities in accessing reproductive health services can be grouped as national barriers related to the health system and individual barriers related to psychological, behavioral, social, physical, economic and education. Attention is drawn to issues such as education and care in reproductive health problems of disabled women, menstrual cycle and hygiene behaviors, sexual life, gynecological examination, family planning, parenting and fertility, sexually contagious infections. Among the health personnel, nurses are at a key point in solving the reproductive health problems of women with disabilities. For this reason, while giving care to disabled women, they should provide ethical and holistic care within the needs of disabled people, away from prejudice. In this review, it is aimed to guide in which areas women with disabilities have problems, the factors affecting them, and the nursing approaches developed for these problems. Keywords: sexual health, disabilities, disabled woman, nurse, reproductive health

Management of complex urethral stricture in public health facilities in developing nations in the 21st century

Management of complex urethral stricture in public health facilities in developing nations in the 21^st century

Drug Inventory Control Analysis at a Primary Level Health Care Facility in Bengaluru Urban, India

Background Almost one third of funds allocated to health centres are spent in buying medicines and health care equipment. The cost and requirement of these medicines vary widely depending on level of healthcare quality of healthcare and requirements of population. Efficient feasible and effective planning of drug inventory is necessary for equal access to healthcare services.Objectives The objectives of this study are to categorize the drugs based on cost criticality aspects and identify those requiring stringent managerial control and to improve the health delivery systems of the hospital.Methods The data related to annual consumption and annual drug expenditure ADE incurred on each drug during the year 2023 in a primary level healthcare facility in Bangalore urban was collected. The drugs were categorized based on ABC and VED. Analysis was done using Microsoft Office Excel version 2021.Results A total of 140 drugs used in the hospital were included in the analysis. ADE on these 140 items for the year 2022 was Rs.1023566.35. ABC analysis showed 44 items 31.4 in category-A 37 items 26.4 in category-B and 59 items 42.14 in category-C which utilized 86.5 9.08 and 4.37 of ADE respectively. VED analysis revealed 31 vital items 22.14 64 essential items 45.7 and 45 desirable items 32.14 which consumed 55.3 16.14 and 28.46 ADE of pharmacy respectively. It has been observed that according to ABC-VED analysis 74.17 19 and 6.8 of ADE belong to categories I II and III respectively.Conclusion The above analysis showed drug classification on basis of usage criticality and cost. It also identified drugs that required effective listing supply and management.nbsp

Designing and Selection of Mixed Relational Complete Chain Sampling Plan Using Variance Principle (RCCSP‐VP)

There are many measurable dimensions for products in industries, and their quality should not deviate too much from the established norm. Therefore, a big part of the consignment’s acceptance is determined by the variance of distributions. In the production of surgical or critical care equipment, measurable dimensions are very important, since each part of the equipment should meet the indicated specification with tolerable variance. Therefore, a procedure for constructing a combined (mixed) sampling plan with a variance measure is provided in this module. This sampling plan supports the medical device engineer in establishing the target dimensions for the quality control of medical instruments because many variations in dimensions result in heavy losses for manufacturers. The relational complete chain sampling plan (RCCSP) is utilized in the II phase inspection to have a significant impact on production quality. The performance measures, algorithm, and design of the mixed sampling plan are provided. The plan is indexed through AQL. In order to choose the plan easily, the table is set up with an example.

A narrative review of staff views about dementia care in hospital through the lens of a systems framework.

Significant numbers of people with dementia are admitted into acute settings. They are likely to face poor health outcomes during hospitalisation. There is the need to fully understand the care provided to people with dementia through novel methods such as a systems approach (i.e. human interactions, policy, environment and equipment). The aim of this literature review is to explore hospital practitioners' views on dementia care and to analyse findings using a systems approach. We conducted a narrative review of primary studies that examined dementia care in acute settings. We analysed a total of 33 papers using Thomas and Harden's thematic synthesis guidelines. Thirty-three papers met the inclusion criteria for the review. The findings were as follows: (1) staff-patient relationships (e.g. coping with difficult behaviour), (2) staff-family relationships (e.g. the benefits of involving families in patient care), (3) staff-staff relationships (e.g. building a robust multidisciplinary team), (4) staff-patient care decisions (e.g. decisions directly related to the patient), (5) the environment (e.g. difficulty in adjusting to the hospital environment), (6) policies (e.g. hospital bureaucratic processes) and (7) equipment (e.g. pain assessment tools). The paper revealed multidimensional challenges in the provision of dementia care within hospitals. We conclude that training programmes, hospital policies and processes aimed at improving outcomes for patients with dementia should adopt a systems approach which focuses on the relational, environmental, procedural and instrumental aspects of the hospital system.