The Experts below are selected from a list of 66 Experts worldwide ranked by ideXlab platform
Eric V Jackson - One of the best experts on this subject based on the ideXlab platform.
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failure mode and effects analysis applied to the maintenance and repair of Anesthetic Equipment in an austere medical environment
International Journal for Quality in Health Care, 2014Co-Authors: Michael A Rosen, Benjamin H Lee, John Sampson, Rahul Koka, Adaora Chima, Onyebuchi U Ogbuagu, Megan K Marx, Thaim B Kamara, Michael Koroma, Eric V JacksonAbstract:Objective. Medical technology designed for Western settings frequently does not function adequately or as intended when placed in an austere clinical environment because of issues such as the instability of the electrical grid, environmental conditions, access to replacement parts, level of provider training and general absence of biomedical engineering support. The purpose of this study was to demonstrate the feasibility of applying failure mode and effects analysis as part of an implementation strategy for medical devices in austere medical settings. Design. Observational case-study. Setting/Participants/Intervention. We conducted failure mode and effects analysis sessions with 16 biomedical engineering technicians at two tertiary-care hospitals in Freetown, Sierra Leone. The sessions focused on maintenance and repair processes for the Universal Anaesthesia Machine. Participating biomedical engineers detailed local maintenance and repair processes and failure modes, including resource availability, communication challenges, use errors and physical access to the machine. Main Outcome Measure(s). Qualitative descriptive themes in barriers perceived and solutions generated by biomedical engineers. Results. Solutions generated involved redesigned work processes to increase the efficiency of identifying machine malfunctions, clinician engagement strategies, a formal plan for acquiring spare parts and plans for improving access to the machine. Follow-up interviews indicated solutions generated were implemented and perceived to be effective. Conclusions. This study demonstrates the feasibility of using the failure mode and effects analysis approach to improve implementation of technology in austere medical environments.
Tippawan Muknumporn - One of the best experts on this subject based on the ideXlab platform.
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factors related to Anesthetic Equipment loss at srinagarind hospital
Srinagarind Medical Journal (SMJ) - ศรีนครินทร์เวชสาร, 2010Co-Authors: Wilawan Somdee, Akkharawat Sinkueakunkit, Kochakorn Palacheewa, Pumpuang Kingsangwal, Tippawan MuknumpornAbstract:Background and Objective: During anesthesia and the post-operative period, standard Equipment and monitoring are essential. Srinagarind hospital has over one thousand items of Equipment for its 20 operating rooms and 2 post-anesthesia care units (PACU). Based on a survey between October 2007 and September 2008, it was discovered that 18 items of Anesthetic Equipment went missing, worth between 30,000 and 40,000 Baht. The objectives of this study were to identify the factors related to Equipment loss and to find strategies to prevent or mitigate losses. Methods : We conducted qualitation research, using basic data regarding Equipment losses derived from a problem-solving fishbone diagram that emerged during a departmental seminar in November 2008. Our responsive study ran between March and August 2009. The department provided the Anesthetic Equipment in all of the operating rooms and PACUs with checklist logs. When Equipment went missing, researchers invited related personnel to discuss the loss and to find strategies for prevention (Focus group discussion). The summary of the data collected and response protocols were later presented at a departmental conference. Results : The focus group discussions during study period involved 150 personnel, comprising anesthesia personnel (60/150, 40%), operating room personnel (30/150, 20%), intensive care personnel (20/150, 13.3%) and laundry personnel (40/150, 26.7%). The study revealed that the intradepartmental factors related to Equipment loss were personnel, work pattern, management, time of work, the involved Equipment and the budget. But extradepartmental factors had specific differences depend on personnel groups. The process resulted in four intradepartmental preventive guidelines and some activities within and outside the department. Conclusions : The factors related to Anesthetic Equipment loss involved both within and outside the department. Preventive guidelines have been established, including some activities both within and outside the department. Keywords : Anesthetic Equipment Loss
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factors related to Anesthetic Equipment loss at srinagarind hospital khon kaen university
ศรีนครินทร์เวชสาร (Srinagarind Medical Journal), 2010Co-Authors: Wilawan Somdee, Akkharawat Sinkueakunkit, Kochakorn Palacheewa, Pumpuang Kingsangwal, Penvisa Naewthong, Somboon Thienthong, Tippawan MuknumpornAbstract:Background and Objective: During anesthesia and the post-operative period, standard Equipment and monitoring are essential. Srinagarind hospital has over one thousand items of Equipment for its 20 operating rooms and 2 post-anesthesia care units (PACU). Based on a survey between October 2007 and September 2008, it was discovered that 18 items of Anesthetic Equipment went missing, worth between 30,000 and 40,000 Baht. The objectives of this study were to identify the factors related to Equipment loss and to find strategies to prevent or mitigate losses. Methods : We conducted qualitation research, using basic data regarding Equipment losses derived from a problem-solving fishbone diagram that emerged during a departmental seminar in November 2008. Our responsive study ran between March and August 2009. The department provided the Anesthetic Equipment in all of the operating rooms and PACUs with checklist logs. When Equipment went missing, researchers invited related personnel to discuss the loss and to find strategies for prevention (focus group discussion). The summary of the data collected and response protocols were later presented at a departmental conference. Results : The focus group discussions during study period involved 150 personnel, comprising anesthesia personnel (60/150, 40%), operating room personnel (30/150, 20%), intensive care personnel (20/150, 13.3%) and laundry personnel (40/150, 26.7%). The study revealed that the intradepartmental factors related to Equipment loss were personnel, work pattern, management, time of work, the involved Equipment and the budget. But extradepartmental factors had specific differences depend on personnel groups. The process resulted in four intradepartmental preventive guidelines and some activities within and outside the department. Conclusions : The factors related to Anesthetic Equipment loss involved both within and outside the department. Preventive guidelines have been established, including some activities both within and outside the department. Keywords : Anesthetic Equipment Loss � sp� �=� d that the entrance skin dose found in skin patients. Set of techniques for patients irradiated for chest radiography. The results revealed that the mean and the third quartile (75 th percentile) dose were 0.2 and 0.23 mGy, respectively, which fairly smaller than the dose IAEA standard reference and other research. Conclusion : The average skin dose patients received in the general chest X-ray imaging. Compared with the reference dose level research found that dose levels lower than any research. Study the radiation dose to the skin of patients received radiation from common imaging method can be measured easily and conveniently. We supposed this study can be adjusted to configure the imaging techniques for recievering less radiation used as a guide to study the dose patients receive from other general imaging radiation, such as general abdominal imaging or spinal imaging. Keywords: Entrance skin dose
Michael A Rosen - One of the best experts on this subject based on the ideXlab platform.
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failure mode and effects analysis applied to the maintenance and repair of Anesthetic Equipment in an austere medical environment
International Journal for Quality in Health Care, 2014Co-Authors: Michael A Rosen, Benjamin H Lee, John Sampson, Rahul Koka, Adaora Chima, Onyebuchi U Ogbuagu, Megan K Marx, Thaim B Kamara, Michael Koroma, Eric V JacksonAbstract:Objective. Medical technology designed for Western settings frequently does not function adequately or as intended when placed in an austere clinical environment because of issues such as the instability of the electrical grid, environmental conditions, access to replacement parts, level of provider training and general absence of biomedical engineering support. The purpose of this study was to demonstrate the feasibility of applying failure mode and effects analysis as part of an implementation strategy for medical devices in austere medical settings. Design. Observational case-study. Setting/Participants/Intervention. We conducted failure mode and effects analysis sessions with 16 biomedical engineering technicians at two tertiary-care hospitals in Freetown, Sierra Leone. The sessions focused on maintenance and repair processes for the Universal Anaesthesia Machine. Participating biomedical engineers detailed local maintenance and repair processes and failure modes, including resource availability, communication challenges, use errors and physical access to the machine. Main Outcome Measure(s). Qualitative descriptive themes in barriers perceived and solutions generated by biomedical engineers. Results. Solutions generated involved redesigned work processes to increase the efficiency of identifying machine malfunctions, clinician engagement strategies, a formal plan for acquiring spare parts and plans for improving access to the machine. Follow-up interviews indicated solutions generated were implemented and perceived to be effective. Conclusions. This study demonstrates the feasibility of using the failure mode and effects analysis approach to improve implementation of technology in austere medical environments.
Daniel P Costa - One of the best experts on this subject based on the ideXlab platform.
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effective field based inhalation anesthesia for ice seals
Marine Mammal Science, 2005Co-Authors: Nicholas J Gales, Julie Barnes, Beth Chittick, Millie Gray, Sarah Robinson, Jennifer M Burns, Daniel P CostaAbstract:Thirty five adult crabeater seals (Lobodon carcinophaga) were anesthetized with combinations of the sedative midazolam and the gaseous Anesthetic isoflurane during three research cruises to the Antarctic Peninsula (∼67°S, 67°W) in the austral winters of 2001 and 2002. Modifications were required to gas Anesthetic Equipment to achieve field portability and sufficient heating to allow operations in temperatures as low as -20°C. Seals were sedated with an average intramuscular dose of midazolam of 0.55 ± 0.14 mg/kg delivered via a pole syringe (n = 32). One seal was not given midazolam and two seals were injected intravenously. Premedication with midazolam provided moderate sedation, making capture and masking practical and safe. Mean induction time with isoflurane was 8 ± 4.8 min. Mean maintenance concentration over the Anesthetic period were 2.3% ± 0.9% of isoflurane. Average recovery time was 18.2 ± 8.8 min. No substantial difficulties were experienced and Anesthetics were easily managed. This drug combination and the use of modified, heated Equipment provide an effective Anesthetic procedure for crabeater seals.
John Sampson - One of the best experts on this subject based on the ideXlab platform.
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failure mode and effects analysis applied to the maintenance and repair of Anesthetic Equipment in an austere medical environment
International Journal for Quality in Health Care, 2014Co-Authors: Michael A Rosen, Benjamin H Lee, John Sampson, Rahul Koka, Adaora Chima, Onyebuchi U Ogbuagu, Megan K Marx, Thaim B Kamara, Michael Koroma, Eric V JacksonAbstract:Objective. Medical technology designed for Western settings frequently does not function adequately or as intended when placed in an austere clinical environment because of issues such as the instability of the electrical grid, environmental conditions, access to replacement parts, level of provider training and general absence of biomedical engineering support. The purpose of this study was to demonstrate the feasibility of applying failure mode and effects analysis as part of an implementation strategy for medical devices in austere medical settings. Design. Observational case-study. Setting/Participants/Intervention. We conducted failure mode and effects analysis sessions with 16 biomedical engineering technicians at two tertiary-care hospitals in Freetown, Sierra Leone. The sessions focused on maintenance and repair processes for the Universal Anaesthesia Machine. Participating biomedical engineers detailed local maintenance and repair processes and failure modes, including resource availability, communication challenges, use errors and physical access to the machine. Main Outcome Measure(s). Qualitative descriptive themes in barriers perceived and solutions generated by biomedical engineers. Results. Solutions generated involved redesigned work processes to increase the efficiency of identifying machine malfunctions, clinician engagement strategies, a formal plan for acquiring spare parts and plans for improving access to the machine. Follow-up interviews indicated solutions generated were implemented and perceived to be effective. Conclusions. This study demonstrates the feasibility of using the failure mode and effects analysis approach to improve implementation of technology in austere medical environments.