Table Of Instruments Research Articles

Short-Cycle Autoclave Sterilization of Instruments in Same-Day Ophthalmic Surgeries

What Is the Issue? The volume of ophthalmic surgeries is increasingly high, with cataract surgery being 1 of the most performed surgeries in Canada. Infections following ophthalmic surgeries, while rare, can cause severe complications that may lead to irreversible vision loss. Reducing postsurgery infections is a high priority in clinical practice. Running a full wrapped, terminal steam sterilization cycle for ophthalmic instruments in autoclaves may be inefficient for ophthalmic surgeries and may cause unnecessary heavy economic and environmental burdens due to high surgical volumes. Using instruments sterilized on a short cycle between sequential same-day ophthalmic surgeries may help improve efficiency and reduce resources used. These instruments are generally processed using autoclaves (i.e., steam sterilizers); the effectiveness of a shorter-cycle method of sterilization is unclear. What Did We Do? To inform decisions regarding the use of autoclaves for short-cycle sterilization for sequential same-day instrument use in ophthalmic surgery, we sought to identify and summarize evidence comparing this method to full-cycle sterilization of wrapped instruments and identify any relevant recommendations. We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published since 2012. One reviewer screened articles for inclusion based on predefined criteria. What Did We Find? In a laboratory setting to simulate sequential same-day procedures, short-cycle sterilization with interrupted dry time for unwrapped ophthalmic instruments is feasibly as effective as full-cycle sterilization for wrapped instruments using the STATIM autoclave. Similarly, short-cycle sterilization with interrupted dry time for contained ophthalmic instruments is feasibly as effective as full-cycle sterilization for contained instruments using the AMSCO autoclave. For sequential same-day ophthalmic procedures, wet instruments sterilized by a short-cycle process with an interrupted dry time can remain sterile for at least 3 minutes if kept in a covered sterilizer containment device. One guideline recommends that wrapped or unwrapped ophthalmic instruments sterilized by a short-cycle process without full drying should be stored in a covered containment device until retrieved by staff wearing sterile gloves and gowns in the operating room for the subsequent surgery after a short delay. Phaco handpieces should be immediately primed with a balanced salt solution and remain wet as they sit on the sterile instrument table. We did not identify any clinical setting evidence from studies or autoclave manufacturers. It is unclear if clinical outcomes differ between patients undergoing sequential same-day ophthalmic surgeries using short-cycle sterilized instruments and those undergoing surgery using full-cycle sterilized instruments. What Does This Mean? Preliminary laboratory evidence and guideline recommendations supporting the use of autoclaves for short-cycle sterilization of instruments for sequential same-day ophthalmic surgeries are available. However, there is no clinical effectiveness evidence available on this process in patient settings. Future research is necessary to understand the clinical safety of using instruments sterilized by short cycles for sequential same-day use for patients undergoing ophthalmic surgeries. In addition to the evidence and recommendations identified, other factors, such as environmental influence, may be useful considerations when making decisions about short-cycle sterilization for sequential same-day instrument use for ophthalmic surgery.

Evaluation of the Excellent Class Program in Improving the Quality of Education in Junior High Schools. Muhammadiyah - Bandung

This study applies the Context, Input, Process, Product (CIPP) program evaluation model with a descriptive qualitative approach. Data collection refers to the CIPP evaluation instrument table which is compiled based on predetermined criteria, through observation, interview, and documentation techniques. Data analysis involves data collection, data reduction, data presentation, drawing conclusions, and data verification. The results show 1. Evaluation of the program context in the number of students who have talents and creativity that are facilitated more optimally. The excellent class program to create superior students and shows that Muhammadiyah schools have quality students. 2. The Input Evaluation applied includes student screening, testing, willingness to join the excellent class. 3. Evaluation of the program performance process is not optimal. The relationship between the implementer and students is going well, with full trust from the parents of students regarding student development. 4. Evaluation of the program's product results showed good achievements, although not yet fully maximized. 80% of Muhammadiyah graduates successfully continued their education to favorite state schools. The superior class program to be continued with the condition of reformulating the initial objectives of the program.

Evaluation Analysis of the Affective Domain in the Merdeka Belajar Kurikulum Merdeka (MBKM) at State Islamic Religious Universities (PTKIN).

The purpose of this article is to understand the concept of evaluating the affective domain, its challenges and implementation strategies in the independent campus learning (MBKM) curriculum at state Islamic religious universities (PTKIN). The method used is library research (Library Research) by collecting data in the form of journal articles, books, these and other sources relevant to the research theme. Data collection was carried out using documentation techniques (documentary study) and analyzed using content analysis techniques. The research results show that 1) The concept of evaluating the affective domain in Merdeka Belajar Kurikulum Merdeka (MBKM) at state Islamic religious universities (PTKIN) consists of five levels: receiving A1, responding to A2, assessing A3, organizing A4 to characterizing with an A4 value. 2) There are five challenges in evaluating the affective domain in independent learning campuses (MBKM) at state Islamic religious universities (PTKIN): Complexity of measuring affective aspects, Diversity of student backgrounds, Integration of religious and spiritual values, Limitations of evaluation instruments, Need for resources competent human resources. 3) The implementation strategy for evaluating the affective domain in Merdeka Belajar Kurikulum Merdeka (MBKM) at state Islamic religious universities (PTKIN) can be created by creating an instrument table containing the observed value aspects: aspect 1, aspect 2, aspect and so on as needed and containing percentage in each aspect. In discussion activities, for example, what is assessed are aspects of participation, contribution and class activity. The criteria are: asking questions, submitting comments on questions and Ethics.

Cognition Analysis of Building Energy Efficiency Labeling System and the Application of Policy Instrument

<p>2021年住商部門佔總排碳量，全國約占21.9%，台北市約佔75.88%。各國皆認為建築能源效率會是住商部門能否達到淨零排放的重要指標，無不積極推動建築能效標示；不過能效標示必須搭配自願性或強制性的政策工具才會發生效果。文獻回顧發現標示制度成功與否取決於標示「感知」、「品質」及「信任」三面向的發展程度。本研究歸納3面向的8個認知構面及其16項評估項目與7項政策工具，經問卷抽樣調查分析，發現「信任」面向之6項重要評估項目最受重視，其中以「評估人員條件」、「培訓認可條件」及「抽複查機制」3項評估項目對標示公信力影響最大。至於「感知」面向則僅有「與建築節能相關職業」(即資訊提供族群)的認知程度較高，未與建築節能議題接觸者，感知普遍不足，與從事建築職業無關。另外，彙整出7項政策工具之評估項目相關性分析表，自願性政策工具明顯較強制性政策工具受青睞；「強制性」的政策工具著重於「標示機構公正性」與「評估人員專業性」，不論是資訊提供或接收者，認知一致，為該政策工具之重點施政作為。「經濟手段」的政策工具，並無偏重那個面向，應從各面向並進，惟職業別與居住地區別特徵認知差異大，應針對不同族群調整施政作法，「資訊透明化」之政策工具，著重於機構公正性、辦理程序嚴謹性，應防止制度容易發生弊端的問題，並彙整出政策工具與評估項目之相關性分析表，供後續推動政策工具的參考。</p> <p> </p><p>In terms of the total carbon emissions accounted for by the residential and commercial sector in 2021, it accounts for approximately 21.9% nationwide and 75.88% in Taipei City. Various countries believe that building energy efficiency will be an important indicator of whether the residential and commercial sectors can achieve net-zero emissions, so they all actively promote building energy efficiency labels; however, energy efficiency labels must be paired with voluntary or mandatory policies to be effective. A review of the literature found that the success of a labeling system usually depends on the degree to which the public has developed three aspects of labeling: "perception", "quality" and "trust". This study summarized the 8 cognitive aspects of the 3 aspects and their 16 evaluation items and 7 policy Instruments. After a questionnaire survey and analysis, it was found that the 6 important evaluation items of the "trust" aspect received the most attention, among which the "evaluator" was the most important. The three evaluation items, "Conditions", "Training Accreditation Conditions" and "Spot Review Mechanism" have the greatest impact on the credibility of the label. As for the "perception" aspect, only "occupations related to building energy conservation" (that is, the information providing group) have a higher level of awareness. Those who have not been exposed to building energy conservation issues generally have insufficient awareness, which has nothing to do with being engaged in the construction profession. In addition, a correlation analysis table of the evaluation items of 7 policy Instruments was compiled. Voluntary policy Instruments are obviously more popular than mandatory policy Instruments; "mandatory" policy Instruments focus on "marking the impartiality of the organization" and "professionalism of the assessor". "Sex", whether the information provider or the receiver has a consistent understanding, is the key governance action of this policy Instrument. The policy Instrument of "economic means" does not focus on one aspect. It should be based on all aspects. However, there are great differences in the recognition of the distinguishing characteristics of occupational gender and place of residence. Governance practices should be adjusted according to different ethnic groups. The policy Instrument of "information transparency" focuses on Regarding the fairness of the institution and the rigor of the processing procedures, we should prevent problems that are prone to malpractice in the system, and compile a correlation analysis table of policy Instruments and assessment items for reference in the subsequent promotion of policy Instruments.</p> <p> </p>

Experimental analysis of airborne contaminant distribution in an operating room with different ventilation schemes

Experimental and numerical investigations were performed in a research operating room to compare laminar air flow and turbulent mixing ventilation systems in reducing the concentrations of airborne germs and surgical smoke in operating room air. In addition, measurements at scattered positions were conducted to find positions that are suited best for airborne monitoring in real-time during surgeries. In the experiments, particle counters were used to sample tracer aerosols originating from the wound area and the facial area of the thermal manikins representing surgical staff. The results showed that it is important to perform monitoring close to the areas with high hygiene requirements. Increasing the air change rate with turbulent mixing ventilation significantly reduced the number of airborne particles, however, not in the surgical microenvironment. Our findings show varying results considering the particle concentration using laminar air flow compared to turbulent mixing ventilation. With laminar air flow, higher contaminant levels are obtained in the areas with a high demand for contamination reduction. In contrast, laminar air flow was more effective in reducing the concentration of surgical smoke in the facial areas of the surgical staff. Regarding airborne germs, monitoring should be performed at the instrument tables and close to the wound area to evaluate the risk for surgical side infections. These results can support the development of guidelines and best practices for operating room ventilation design and maintenance to improve patient safety and reduce the risk of healthcare-associated infections.

Character Education In The Common People Novels By Andrea Hirata

Character education is a crucial aspect of all circles of society, especially for children. This study aims to describe the form and impact of character education, hard work, and social care in the Common people novels by Andrea Hirata. The research was studied using a literary sociology approach. The source of data in this study is the Common people novels by Andrea Hirata, paying attention to the unit of story, sentences, actions, thoughts, and narratives in the novel. The data found is processed through several steps: determining the source, collecting data, grouping data, and assigning a code number to the research instrument table. Data analysis techniques are carried out in several stages: simplification, data checking, data presentation, and conclusions. The results of this study show that various forms of character education were found. The forms of character education are hard work, practice seriously, full of confidence, passion, and never giving up. The form of social care character education is to assist others and respect others. This research shows that literary works can be a means of learning character education for readers. This is because literary works are a mirror of the reality of life.

Intraoperative airborne bacterial contamination and covered sterile instrument tables: Is the standard two-drape method better than the single-drape method? Experimental study

BackgroundWe purposed to assess and compare the effectiveness and safety of covering with the single-drape method versus the standard two-drape method recommended by the Association of Perioperative Registered Nurses (AORN) in reducing contamination of the prepared sterile instrument tables (PSITs) with airborne bacteria-carrying particles (ABCPs). MethodsSix agar plates (n = 810) were used to measure the load of ABCPs on each PSIT both at rest (static period) and during a simulated surgical operation (dynamic period). At every time point, this arrangement was repeated two times during data collecting (81 PSITs were established in total). Experimental groups contained PSITs covered with the single-drape and the standard two-drape methods or no cover. We collected the plates after 60, 120, 180, 240 min, and 24 h. ResultsAt all-time points, covering the PSITs during static and dynamic operating theater (OT) conditions led to a meaningfully reduced load of ABCPs on the PSITs (P < 0.05). Moreover, no differences were found between the recommended two-drape method by the AORN and the single-drape method (P > 0.05). ConclusionCovering the PSITs during nonuse and active surgeries helps prevent the PSITs from becoming contaminated and thus can help decrease the incidence of surgical wound infection (SWI). Covering the PSITs with a sterile drape helps protect them from ABCPs that may be shed from the hair and skin of OT nurses (OTNs). Our study showed no priority for using the standard two-drape method compared with the single-drape method.

Telemedical Support Using Smartphones for Spine Surgery in Low- and Middle-Income Countries.

Objective: Low- and middle-income countries (LMICs) face many challenges compared to industrialized nations, most notably in regard to the health care system. Patients often have to travel long distances to receive medical care with few reliable transportation mechanisms. In time-critical emergencies, this is a significant disadvantage. One specialty that is particularly affected by this is spine surgery. Within this field, traumatic injuries and acutely compressive pathologies are often time-critical. Increasing global networking capabilities through internet access offers the possibility for telemedical support in remote regions. Recently, high-performance cameras and processors became available in commercially available smartphones. Due to their wide availability and ease of use, this could provide a unique opportunity to offer telemedical support in LMICs. Methods: We conducted a feasibility study with a neurosurgical institution in east Africa. To ensure telemedical support, a commercially available smartphone was selected as the experimental hardware. Preoperatively, resolution, contrast, brightness, and color reproduction were assessed under theoretical conditions using a test chart. Intraoperatively, the image quality was assessed under different conditions. In the first step, the instrumentation table was displayed, and the mentor surgeon marked an instrument that the mentee surgeon should recognize correctly. In the next evaluation step, the surgical field was shown on film and the mentor surgeon marked an anatomical structure, and in the last evaluation step, the screen of the X-ray machine was captured, and the mentor surgeon again marked an anatomical structure. Subjective image quality was rated by two independent reviewers using the similar modified Likert scale as before on a scale of 1-5, with 1 indicating inadequate quality and 5 indicating excellent quality. Results: The image quality during the video calls was rated as sufficient overall. When evaluating the test charts, a quality of 97% ± 5 on average was found for the chart with the white background and a quality of 84% ± 5 on average for the chart with the black background. The color reproduction, the contrast, and the reproduction of brightness were rated excellent. Intraoperatively, the visualization of the instrument table was also rated excellent. Visualization of the operative site was rated 1.5 ± 0.5 on average and it was not possible to recognize relevant anatomical structures with the required confidence for surgical procedures. Image quality of the X-ray screen was rated 1.5 ± 0.9 on average. Conclusion: Current generation smartphones have high imaging performance, high computing power, and excellent connectivity. However, relevant anatomical structures during spine surgery procedures and on the X-ray screen in the operating room could not be identified with reliability to provide adequate surgical support. Nevertheless, our study showed the potential in smartphones supporting surgical procedures in LMICs, which could be helpful in other surgical fields.

Ozonated water in disinfection of hospital instrument table

The walls, ceiling, and floor of a surgical environment, as well as the surfaces used in this place, must be submitted to a disinfection protocol to minimize nosocomial infections. Health regulations recommend two stages; the first is characterized by cleaning procedures, mainly using an enzymatic detergent, and the second is use of a disinfection agent. Ozone is a natural substance that has a relevant oxidative property for inactivating microorganisms and has emerged as an interesting agent in the hospital environment. Compared with conventional chemical products for disinfection, ozonated water has advantages such as a lack of storage control, disposal, and handling safety. The objective of this study was to use ozonated water as a disinfectant agent on a hospital metal surface, in comparison with 70% alcohol. The degree of disinfection of the metal surface was quantitatively analyzed with use of an instrument by bioluminescence for a disinfection test. Qualitative terms indicated gram-positive cocci microorganisms and yeasts, suggesting that bacteria and fungi from the environment were identified. After the use of ozonated water as a disinfectant, the quantitative analysis indicated values below 100 RLU, showing evidence of a surface suitable for use in surgical procedures. The use of ozonated water as a disinfectant agent for a metal surface in a hospital environment showed more effectiveness than 70% alcohol. Thus, ozonated water is a promising agent for disinfecting surfaces in surgical environments.

Kompetensi Menulis Karya Ilmiah Mahasiswa Program Studi Manajemen STIE Manajemen Bisnis Indonesia Depok Jawa Barat

This study aims to determine students' ability to write scientific papers and also find out the obstacles experienced by students in scientific writing. Management study program students at STIE MBI (Indonesian Business Management) are the object of this research, and quantitative-descriptive is the research method used in this research. All students enrolled in the STIE MBI management study program for semester 7 (seven) of the 2022–2023 academic year were included in this study population. The sample consisted of 35 students who were randomly selected. Data for the Risk Management and Organizational Culture course are collected in the form of scientific papers, which are then analyzed using research instrument tables. Based on the research findings, it was found that 26% of the students got good marks, followed by 51% who got enough marks (18 students), 14% who got low scores (5 students), and 9% who got very low scores (3 students). So the conclusion is that the competency abilities of STIE MBI (Indonesian Business Management) management study program students in writing scientific papers are on average sufficient or moderate; it is necessary to improve.

PToPI: A Comprehensive Review, Analysis, and Knowledge Representation of Binary Classification Performance Measures/Metrics.

Although few performance evaluation instruments have been used conventionally in different machine learning-based classification problem domains, there are numerous ones defined in the literature. This study reviews and describes performance instruments via formally defined novel concepts and clarifies the terminology. The study first highlights the issues in performance evaluation via a survey of 78 mobile-malware classification studies and reviews terminology. Based on three research questions, it proposes novel concepts to identify characteristics, similarities, and differences of instruments that are categorized into ‘performance measures’ and ‘performance metrics’ in the classification context for the first time. The concepts reflecting the intrinsic properties of instruments such as canonical form, geometry, duality, complementation, dependency, and leveling, aim to reveal similarities and differences of numerous instruments, such as redundancy and ground-truth versus prediction focuses. As an application of knowledge representation, we introduced a new exploratory table called PToPI (Periodic Table of Performance Instruments) for 29 measures and 28 metrics (69 instruments including variant and parametric ones). Visualizing proposed concepts, PToPI provides a new relational structure for the instruments including graphical, probabilistic, and entropic ones to see their properties and dependencies all in one place. Applications of the exploratory table in six examples from different domains in the literature have shown that PToPI aids overall instrument analysis and selection of the proper performance metrics according to the specific requirements of a classification problem. We expect that the proposed concepts and PToPI will help researchers comprehend and use the instruments and follow a systematic approach to classification performance evaluation and publication.

Why multi-tier surgical instrument table matters? An ergonomic analysis from mento-physical demand perspectives

Using traditional back tables (BT) in operating rooms (OR) can lead to high physical/cognitive demand on nurses due to repetitive manual material handling activities. A multi-tier table (MTT) has been developed to relieve such stressors by providing extra working surfaces to avoid stacking the instrument trays and facilitate access to surgical tools. In this study, sixteen participants performed lifting/lowering and instrument findings tasks on each table, where kinematics, kinetics, subjective, and performance-related measures were recorded. Results indicated that MTT required lesser shoulder flexion (p-value<0.001), ∼14% lower shoulder loads (0.012), task completion time (<0.001), and cognitive/physical workloads (<0.004). Although peak low-back demands were ∼15% higher using MTT, the number of lifts to complete the same task was 60% lower, leading to lower cumulative demand on the low-back musculature. Utilizing MTT in OR could reduce demand and increase nurses' efficiency, leading to reduced risk of WMSDs and the total time of surgery.

Prevalence and investigations of bacterial contamination in dental healthcare associated environment

Microbial contamination of medical substrate surface of dental parts touched or exposed to blood and saliva of patients can act as a reservoir for pathogenic bacteria, resulting in cross-contamination. For this reason, presence of oral microorganisms in dental clinics is a major source of dental contamination and infection worldwide. The work described here aimed to determine the presence of bacteria on variety of dental clinic surfaces including a dental chair arm rest, a sink/faucet, the floor beneath a dental chair; a towel dispenser, handles connected to a light and to an instrument table; dental record paper; an X-ray viewer and finally, a bench and head-rest in five separate departments (pediatric dentistry, implant, dental prosthetics, oral medicine and restorative dentistry) of the King Saud University Dental Hospital, both before and after patient treatment. The isolation and identification of bacterial colonies was achieved using a range of methods such as using a Vitek2 automated system. The results showed that all surfaces in different departments were contaminated with bacteria, most notably in the Implant Department, while much less bacterial contamination was reported in the Department of Oral Medicine. The most commonly isolated bacteria were species of, Staphylococcus, Streptococcus, Pseudomonas, Bacillus and Micrococcus.

Instrument tables equipped with local unidirectional airflow units reduce bacterial contamination during orthopedic implant surgery in an operating room with a displacement ventilation system

SummaryBackgroundAirborne bacteria present in the operating room may be a cause of surgical site infection, either contaminating the surgical wound directly, or indirectly via e.g. surgical instruments. The aim of this study was to evaluate if instrument and assistant tables equipped with local unidirectional airflow reduce bacterial contamination of the instrument area to ultra clean levels, during orthopedic implant surgery in an operating room with displacement ventilation.MethodsLocal airflow units of instrument and assistant tables were either active or inactive. Colony forming units were sampled intraoperatively from the air above the instruments and from instrument dummies. A minimum of three air samples and two-three samples from instrument dummies were taken during each surgery. Samples were incubated on agar for total aerobic bacterial count. The mean air and instrument contamination during each surgery was calculated and used to analyze the difference in contamination depending on use of local airflow or not. All procedures were performed in the same OR.Results188 air and 124 instrument samples were collected during 48 orthopedic implant procedures. Analysis showed that local unidirectional airflow above the surgical instruments significantly reduced the bacterial count in the air above assistant table (P<0.001) and instrument table (P=0.002), as well as on the instrument dummies from the assistant table (P=0.001).ConclusionsInstrumentation tables equipped with local unidirectional airflow protect the surgical instruments from bacterial contamination during orthopedic implant surgery and may therefore reduce the risk of indirect wound contamination.

Clinical Issues—April 2022

Perioperative care of the patient with alpha-gal syndrome Key words: alpha-gal syndrome (AGS), red meat allergy, allergic reaction, mammalian-derived ingredients, gelatin. Overnight storage of sterile supplies Key words: sterile supplies, event-related sterility, terminal cleaning, damp dusting, instrument table. Unsterile medication cartridges Key words: dental cartridge, local anesthesia, lidocaine, alcohol, sterile field. Personnel traffic into the OR Key words: OR traffic, door openings, airflow, environmental contamination, automatic doors.

On the value and limitations of incorporating a \u201cclean phase\u201d into the surgical treatment of prosthetic joint infections \u2013 an illustrative cadaveric study using fluorescent powder

PurposesA septic revision of an artificial joint is routinely split up in a so-called dirty phase and a clean phase. The measures taken to initiate the start of the clean phase vary significantly between musculoskeletal infection centers. We performed simulations of one-step exchanges of infected THAs and sought to 1) determine the effect of different clean phase protocols on the sterile field, and 2) determine whether or not it is possible to re-implant the new prosthesis completely clean.MethodsNine fresh frozen cadaveric hips were used and primary THA was undertaken via a direct anterior approach. Before implantation of the components varying amounts of fluorescent powder (GloGerm) were deposited, simulating bacterial infection. Second, a one-step exchange was performed via a posterolateral approach. After implant removal, debridement, and lavage, randomization determined which clean phase protocol was followed, i.e. no, some or full additional measures. Finally, the new prosthesis was re-implanted.In order to determine the effect of different clean phase protocols on contamination of the sterile field standardized UV light-enhanced photographs were obtained of 1) the gloves, 2) the instrument table, 3) the drapes, and 4) the wound and these were ranked on cleanliness by a blinded panel of hip surgeons.In order to determine whether or not it is possible to re-implant the prosthesis completely clean, the implant was taken out again at the end of the one-step exchange and inspected for contamination under UV light.ResultsThe gloves, the instrument table, the drapes and the wound were significantly cleaner after a clean phase using full additional measures compared to partial or no additional measures (p < 0.000). Partial measures were able to reduce some of the contamination of the gloves and the wound, but had no effect on the drapes and the instrument table. All re-implanted implants were contaminated with some amount of fluorescent powder at the end of the one-step exchange.ConclusionsWe advise to incorporate a clean phase with full additional measures into the surgical treatment of prosthetic joint infections, as partial measures seem to be a poor compromise.Level of evidenceNot applicable (cadaveric study).

Constructing an Instrument for Assessing the Internalization and Actualization of Cultural Values toward English for Foreign Language Learners

This study is aimed at developing an instrument to assess learners’ internalization and actualization of cultural values through English for foreign language learning. The five phases of instructional design proposed by Cennamo and Kalk (2019) guided the research and development. The five phases of instructional design include (1) defining key terms and exploring the need to develop an instrument from a practical perspective while taking into account any theoretical gaps; (2) creating the instrument grid design and table of specifications for the design; (3) developing and modeling the instrument; (4) refining the instrument using input from forum group discussions and expostulating with expert judgments; and (5) presenting the product and testing it to the learners. The research consisted of a questionnaire, observation, and interview guide. The technique used to analyze the data was an exploratory factor analysis (EFA) with the factor loading determined by the number of samples in this research. We used the Kaiser-Meyer-Olkin (KMO) test to measure data sufficiency with levels greater than 0,05 (KMO&gt;0,05). After analyzing the data, the results revealed 0,587 with the significance of 0,000 showing that, for assessing internalization and actualization of cultural values, there were 25 items with seven factors: deserving the value of achievement, self-confidence, creativity, respect, discipline, nationalism, and tolerance.

Measuring and evaluating standardization of scrub nurse instrument table setups: a multi-center study

ObjectivesIn-depth knowledge about surgical processes is a crucial prerequisite for future systems in operating rooms and the advancement of standards and patient safety in surgery. A holistic approach is required, but research in the field of surgical instrument tables, standardized instrument setups and involved personnel, such as nurses, is sparse in general. The goal of this study is to evaluate whether there is an existing standard within clinics for an instrument table setup. We also evaluate to which extent it is known to the personnel and whether it is accepted.Materials and MethodsThe study makes use of the Nosco Trainer, a scrub nurse training and simulation system developed to analyze various aspects of the workplace of scrub nurses. The system contains a virtual instrument table, which is used to perform and record instrument table setups. We introduce a metric which delivers a measurable score for the similarity of surgical instrument table setups. The study is complemented with a questionnaire covering related aspects.ResultsFifteen scrub nurses of the Otolaryngology departments at three clinics in Germany and Switzerland performed a table setup for a Functional Endoscopic Sinus Surgery intervention and completed the questionnaire. The analysis of the developed metric with a leave one out cross-validation correctly allocated 14 of the 15 participants to their clinic.DiscussionIn contrast to the identified similarities of table setups within clinics with the collected data, only a third of the participants confirmed in the questionnaire that there is an existing table setup standard for Functional Endoscopic Sinus Surgery interventions in their facility, but almost three quarters would support a written standard and acknowledge its possible benefits for trainees and new entrants in the operating room.ConclusionsThe structured analysis of the surgical instrument table using a data-driven metric for comparison is a novel approach to gain deeper knowledge about intra-operative processes. The insights can contribute to patient safety by improving the workflow between surgeon and scrub nurse and also open the way for goal-oriented standardization.

Do room air temperature and human activity affect the particle concentration under real surgical procedures in operating rooms with mixing ventilation? - An experimental study at St. Olavs hospital

The objective of this study is to explore the effects of different room temperatures and different types of activities on the indoor air quality in the operating room during surgery. Three mock-up surgeries were performed at 21 °C, 23 °C, and 25 °C at St. Olavs hospital in Norway. The effects of the surgeon’s activity and nurse's movement on the concentration of particulate matter at the surgical site and instrument table were compared. The results show that the concentrations of particles at both the surgical site and the instrument table are the lowest at room temperature of 23 °C. The activity of the surgeon was the main factor leading to the increase in the concentration of particulate matter with the size 0.3-0.5 μm at the surgical site, while the nurse movement led to the increase in the concentration of particulate matter with the larger size. At all room temperatures, the movement of the distribution nurse had a greater effect than the activity of the surgeon on the increase of the concentration of particles at the instrument table. In addition, the intensity of the particulate source may be factors affecting the concentration of particulate matter. Therefore, it is recommended that distribution nurses should avoid unnecessary activities during the operation.

Assessment of the Antimicrobial Efficacy of Chlorine Dioxide as Disinfectant in Veterinary Operating Rooms

This study was conducted to assess the efficacy of Chlorine dioxide (ClO2) as a disinfectant in veterinary operating rooms. Four surfaces (surgical table, drain of surgical table, instrument table and wall) inside the operating room of four randomly selected veterinary facilities located within the Greater Manila Area were screened for the bacterial count before and after one hour of disinfection with a ClO2-based disinfectant and a Sodium hypochlorite-based (NaClO) disinfectant. The average bacterial load before the application of treatments to the different surfaces of the operating room of the four facilities included in this study was 70.65cfu/mL. The T-test revealed that the mean log10 reduction of ClO2 was significantly higher compared to the mean log10 reduction of NaClO. This clearly demonstrates that ClO2 was more potent than NaClO in decreasing bacterial colonies on the surfaces of veterinary operating rooms. Results of this study also suggest that the type of surface material affects the disinfection rate and should always be considered in a disinfection protocol. Based on the bacterial characterization of isolated bacteria, a low concentration of ClO2 would be sufficient to produce an immediate effect against gram-negative bacteria and gram-positive in the absence of organic materials.