Location Of Dispensers Research Articles

Tailored positioning and number of hand rub dispensers: the fundamentals for optimized hand hygiene compliance

Availability of alcohol-based hand rub (ABHR) dispensers at positions adapted to the work flow of healthcare workers (HCWs) is decisive in order to carry out indication-based hand rubbing. Although requirements and guidelines regarding the positioning of ABHR dispensers are in place, scientific evidence is often lacking. In order to analyse the impact of the location and number of ABHR dispensers on hand hygiene performance, additional dispensers were systematically placed in patient rooms in a surgical 38-bed ward at Marburg University Hospital, Germany to complement the existing dispenser locations. ABHR use was monitored continuously before and after complementation using the NosoEx hand hygiene monitoring system. The ward had 53 dispensers before the intervention and 82 dispensers after the intervention. The addition of dispensers increased ABHR consumption across the entire ward. Before the intervention, mean consumption was 20.6 mL/patient-day, whereas mean consumption after the intervention was 25.3 mL/patient-day. Depending on the combination of dispenser locations, consumption increased through targeted supplementation in patient rooms. The presence of two or three dispensers per patient room resulted in significantly greater ABHR consumption compared with one dispenser per patient room. The preferred location combinations were entrance-front bed-back bed and entrance-foot end. ABHR consumption can be increased significantly by optimizing the position and number of dispensers. The outstanding factors are visibility and integrability of dispenser use into the work flow; in particular, a dispenser should be positioned in the entrance area. Recommendations should be optimized with regard to the required number and location of dispensers in patient rooms.

Ecological Location of a Water Source and Spatial Dynamics of Behavior Under Temporally Scheduled Water Deliveries in a Modified Open-Field System: An Integrative Approach.

It has been reported in non-contingent schedules that the variety of patterns of behavior is affected by the temporal variation of water deliveries. While temporal variation is accomplished by delivering water at fixed or variable times, spatial variation is usually accomplished by varying the number of dispensers and distance among them. Such criteria do not consider the possible ecological relevance of the location of water dispensers. Nevertheless, it is plausible to suppose that the intersection of the programed contingencies (e.g., time-based schedules), the ecological differentiated space (e.g., open vs. closed zones), and the relative location of relevant objects and events (e.g., location of the water source—peripherical vs. center zone) could set up an integrated system with the behavioral patterns of the organism. In the present study, we evaluated the eco-functional relevance of two locations of the dispensers upon behavioral dynamics in Wistar rats using fixed and variable time schedules in a modified open-field system. In Experiment 1, three subjects were exposed to a fixed time 30-s water delivery schedule. In the first condition, the water dispenser was located at the center of the experimental chamber. In the second condition, the water dispenser was located at the center of a wall of the experimental chamber. Each location was present for 20 sessions. In Experiment 2, conditions were the same, but a variable time schedule was used. Routes, distance to the dispenser, recurrence patterns, time spent in zones, entropy, and divergence were analyzed. Our findings suggest a robust differential relevance of the location of the dispensers that should be considered in studies evaluating behavioral dynamics. Results are discussed from an integrative, ecological-parametric framework.

The Research on Knowledge Sharing and Location Selection of Pharmaceutical Logistics Supply

Based on the literature of medicine vending machine and facility location selection, combined with the characteristics of automatic drug dispenser equipment, from the three aspects of social factors, facility service and customer behavior, this paper sums up 10 typical factors that affect the location of dispensers. Based on the survey of Quanzhou residents and statistical analysis of the survey data, the current use of automatic drug dispensers in Quanzhou is obtained. By using the Interpretative Structural Model and Analytic Hierarchy Process, the relationship between factors and their influence on the location of medicine vending machine is analyzed. At the same time, based on the current use of automatic drug dispensers in Quanzhou, the author has made recommendations to its pharmaceutical retail chain enterprises, and to other areas in the future medicine vending machine location recommendations, so as to improve the utility of medicine vending machine in public services and convenience.

Evaluation of hand hygiene compliance and associated factors with a radio-frequency-identification-based real-time continuous automated monitoring system

Hand hygiene is a major means for preventing healthcare-associated infections. One critical point in understanding poor compliance is the lack of relevant markers used to monitor practices systematically. This study analysed hand hygiene compliance and associated factors with a radio-frequency-identification-based real-time continuous automated monitoring system in an infectious disease ward with 17 single bedrooms. Healthcare workers (HCWs) were tracked while performing routine care over 171 days. A multi-level multi-variate logistics model was used for data analysis. The main outcome measures were hand disinfection before entering the bedroom (outside use) and before entering the patient care zone, defined as the zone surrounding the patient's bed (inside/bedside use). Variables analysed included HCWs' characteristics and behaviour, patients, room layouts, path chains and duration of HCWs' paths. In total, 4629 paths with initial hand hygiene opportunities when entering the patient care zone were selected, of which 763 (16.5%), 285 (6.1%) and 3581 (77.4%) were associated with outside use, inside/bedside use and no use, respectively. Hand hygiene is caregiver-dependent. The shorter the duration of the HCW's path, the worse the bedside hand hygiene. Bedside hand hygiene is improved when one or two extra HCWs are present in the room. Hand hygiene compliance at the bedside, as analysed using the continuous monitoring system, depended upon the HCW's occupation and personal behaviour, number of HCWs, time spent in the room and (potentially) dispenser location. Meal tray distribution was a possible factor in the case of failure to disinfect hands.

Hydrogen field test standard: Laboratory and field performance

The National Institute of Standards and Technology (NIST) developed a prototype field test standard (FTS) that incorporates three test methods that could be used by state weights and measures inspectors to periodically verify the accuracy of retail hydrogen dispensers, much as gasoline dispensers are tested today. The three field test methods are (1) gravimetric, (2) Pressure, Volume, Temperature (PVT), and (3) master meter. The FTS was tested in NIST's Transient Flow Facility with helium gas and in the field at a hydrogen dispenser location. All three methods agree within 0.57% and 1.53% for all test drafts of helium gas in the laboratory setting and of hydrogen gas in the field, respectively. The time required to perform six test drafts is similar for all three methods, ranging from 6h for the gravimetric and master meter methods to 8h for the PVT method.The laboratory tests show that (1) it is critical to wait for thermal equilibrium to achieve density measurements in the FTS that meet the desired uncertainty requirements for the PVT and master meter methods; in general, we found a wait time of 20min introduces errors <0.1% and <0.04% in the PVT and master meter methods, respectively and (2) buoyancy corrections are important for the lowest uncertainty gravimetric measurements.The field tests show that sensor drift can become a largest component of uncertainty that is not present in the laboratory setting. The scale was calibrated after it was set up at the field location. Checks of the calibration throughout testing showed drift of 0.031%. Calibration of the master meter and the pressure sensors prior to travel to the field location and upon return showed significant drifts in their calibrations; 0.14% and up to 1.7%, respectively. This highlights the need for better sensor selection and/or more robust sensor testing prior to putting into field service. All three test methods are capable of being successfully performed in the field and give equivalent answers if proper sensors without drift are used.

A systematic approach for the location of hand sanitizer dispensers in hospitals

Compliance with hand hygiene practices is directly affected by the accessibility and availability of cleaning agents. Nevertheless, the decision of where to locate these dispensers is often not explicitly or fully addressed in the literature. In this paper, we study the problem of selecting the locations to install alcohol-based hand sanitizer dispensers throughout a hospital unit as an indirect approach to maximize compliance with hand hygiene practices. We investigate the relevant criteria in selecting dispenser locations that promote hand hygiene compliance, propose metrics for the evaluation of various location configurations, and formulate a dispenser location optimization model that systematically incorporates such criteria. A complete methodology to collect data and obtain the model parameters is described. We illustrate the proposed approach using data from a general care unit at a collaborating hospital. A cost analysis was performed to study the trade-offs between usability and cost. The proposed methodology can help in evaluating the current location configuration, determining the need for change, and establishing the best possible configuration. It can be adapted to incorporate alternative metrics, tailored to different institutions and updated as needed with new internal policies or safety regulation.

Conspicuous vs customary location of hand hygiene agent dispensers on alcohol-based hand hygiene product usage in an intensive care unit.

Hand washing is considered the single most important nosocomial infection-control strategy, yet compliance rarely meets levels recommended by infection control authorities. To determine whether placement of hand hygiene foam dispensers in more conspicuous positions and closer proximity to patients would increase use of infection control agents as measured by volume of product used. Further, to ascertain the influence of dispenser placement vs the number of dispensers available on usage by volume. This prospective, observational study conducted in an intensive care unit was composed of three observation periods. A control period with standard agent dispenser location (8 dispensers) was followed by two experimental periods: (1) "conspicuous and immediate proximity to patient" placement (16 dispensers) and (2) standard locations with a dramatic increase in the number of dispensers (36 dispensers). Volume of use for alcohol-based hand hygiene agent during the three observation periods revealed a statistically significant increase in daily consumption after conspicuous and proximate positioning of dispensers (P<.001). However, increasing the number of dispensers did not increase agent use (P=.196). More conspicuous placement of dispensers containing alcohol-based hand hygiene agent (ie, immediate proximity to patients) resulted in statistically and clinically significant increases in product usage. An increase in the number of dispensers did not increase usage. The impact of dispenser positioning on usage by volume for these highly effective products should be considered when planning and implementing intensive care unit infection-control policies.

Method for fabricating a hearing aid shell and mold incorporating test fitting by the user

In a method for fabricating a hearing aid device, a hearing impaired person visits an audiologist at a dispenser location, and is examined to determine electronic settings for a hearing aid to correct the person's hearing impairment. At the same visit, an ear mold of the patient is obtained, which is scanned to produce a three-dimensional data set. A prototype is produced from the hearing aid data set, that does not contain any electronic components, and the prototype is test fitted with the patient. By interaction between the patient and the audiologist, the prototype is modified as needed, with each modification resulting in an updated three-dimensional data set being generated. When the prototype is acknowledged by the patient as being a comfortable fit, the three-dimensional data that were used to create the acceptable prototype are electronically transmitted to a fabrication site, at which the hearing device is manufactured therefrom. The hearing device is then sent to a location at which it is available to the patient.

Experimental study on hydrogen explosions in a full-scale hydrogen filling station model

In order for fuel cell vehicles to develop a widespread role in society, it is essential that hydrogen refuelling stations become established. For this to happen, there is a need to demonstrate the safety of the refuelling stations. The work described in this paper was carried out to provide experimental information on hydrogen outflow, dispersion and explosion behaviour. In the first phase, homogeneous hydrogen–air mixtures of a known concentration were introduced into an explosion chamber and the resulting flame speed and overpressures were measured. Hydrogen concentration was the dominant factor influencing the flame speed and overpressure. Secondly, high-pressure hydrogen releases were initiated in a storage room to study the accumulation of hydrogen. For a steady release with a constant driving pressure, the hydrogen concentration varied as the inlet airflow changed, depending on the ventilation area of the room, the external wind conditions and also the buoyancy induced flows generated by the accumulating hydrogen. Having obtained this basic data, the realistic dispersion and explosion experiments were executed at full-scale in the hydrogen station model. High-pressure hydrogen was released from 0.8 to 8.0 mm nozzle at the dispenser position and inside the storage room in the full-scale model of the refuelling station. Also the hydrogen releases were ignited to study the overpressures that can be generated by such releases. The results showed that overpressures that were generated following releases at the dispenser location had a clear correlation with the time of ignition, distance from ignition point.

The influence of drinker location and colour on drinking behaviour and water intake of newborn pigs under hot environments

The effect of drinker location within the farrowing crate in relation to its microenvironment and the effect of dispenser colour on drinking behaviour and water intake of newborn pigs for the first two days of their lives were studied. In the first trial, 16 sows were randomly assigned to four treatment groups with the piglet's water dispenser placed in the front right (FR), front left (FL), back right (BR) or back left (BL) corner of the farrowing pen, respectively. In the second trial nine sows were randomly assigned to three treatment groups with the piglets’ water dispenser, placed in the front left corner of the farrowing pen, and coloured as red (CR), green (CG) or blue (CB), respectively. Trials commenced between 08:00 and 10:00 h on the first morning after the litters were born and the piglets’ age was considered to be zero (“age”) by that time. The average age of the piglets at their first visit to water dispensers was 15.9 ± 1.8 h. The newborn pigs visited the drinker more frequently ( P < 0.001) during daytime than during night, with two peaks soon after sow feeding time. The duration of drinking time was long at the time of higher (noon) and shorter at the time of lowest (early morning) temperatures ( P < 0.01) in the farrowing house, respectively. The greatest attention at the drinkers occurred soon after suckling ( P < 0.001). The longest time spends at the drinker during the first visits and decreased as the pigs visited dispensers repeatedly. The profile of visit frequency and duration differed between piglet sexes ( P < 0.001). The pigs that did not visit the drinker grew slower and were lighter at 48 h of age than the pigs visited the drinker. First visit and overall mean visit age were significantly shorter for BL than for FR and BR groups. Piglets visited the FL drinker for shorter time than the others. Water consumption per pig/24 h was lower for FL and higher for BL groups ( P < 0.05). Water consumption was higher for CR and CB groups than for CG group. The overall mean visit age was shorter for CG than for CB group. Significant interactions were observed between sex and colour groups for the number of visits ( P < 0.05). The results of the present study revealed that water dispenser use by newborn piglets is characterised by diurnal and between two successive milk consumptions distributions. Water consumption by piglets from birth to 48 h of their lives is strongly influenced by water dispenser location in the farrowing pen and the dispenser colour. It also appears that males and females behave differently to the three colour dispensers used in this study.