The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Christian D Nilson - One of the best experts on this subject based on the ideXlab platform.
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outbreak of toxic anterior segment syndrome following cataract surgery associated with impurities in autoclave steam moisture
Infection Control and Hospital Epidemiology, 2006Co-Authors: Walter C. Hellinger, Saiyid Akbar Hasan, Laura P Bacalis, Deborah M Thornblom, Susan C Beckmann, Carina Blackmore, Terri S Forster, Jason F Tirey, Mary J Ross, Christian D NilsonAbstract:Background. Toxic anterior segment syndrome (TASS), a complication of cataract surgery, is a sterile inflammation of the anterior chamber of the eye. An outbreak of TASS was recognized at an outpatient Surgical center and its affiliated hospital in December 2002. Methods. Medical records of patients who underwent cataract surgery during the outbreak were reviewed, and Surgical team members who participated in the operations were interviewed. Potential causes of TASS were identified and eliminated. Feedwater from autoclave steam generators and steam condensates were analyzed by use of spectroscopy and ion chromatography. Results. During the outbreak, 8 (38%) of 21 cataract operations were complicated by TASS, compared with 2 (0.07%) of 2,713 operations performed from January 1996 through November 2002. Results of an initial investigation suggested that cataract Surgical Equipment may have been contaminated by suboptimal Equipment reprocessing or as a result of personnel changes. The frequency of TASS decreased (1 of 44 cataract operations) after reassignment of personnel and revision of Equipment reprocessing procedures. Further investigation identified the presence of impurities (eg, sulfates, copper, zinc, nickel, and silica) in autoclave steam moisture, which was attributed to improper maintenance of the autoclave steam generator in the outpatient Surgical center. When impurities in autoclave steam moisture were eliminated, no cases of TASS were observed after more than 1,000 cataract operations. Conclusion. Suboptimal reprocessing of cataract Surgical Equipment may evolve over time in busy, multidisciplinary Surgical centers. Clinically significant contamination of Surgical Equipment may result from inappropriate maintenance of steam sterilization systems. Standardization of protocols for reprocessing of cataract Surgical Equipment may prevent outbreaks of TASS and may be of assistance during outbreak investigations.
Walter C. Hellinger - One of the best experts on this subject based on the ideXlab platform.
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outbreak of toxic anterior segment syndrome following cataract surgery associated with impurities in autoclave steam moisture
Infection Control and Hospital Epidemiology, 2006Co-Authors: Walter C. Hellinger, Saiyid Akbar Hasan, Laura P Bacalis, Deborah M Thornblom, Susan C Beckmann, Carina Blackmore, Terri S Forster, Jason F Tirey, Mary J Ross, Christian D NilsonAbstract:Background. Toxic anterior segment syndrome (TASS), a complication of cataract surgery, is a sterile inflammation of the anterior chamber of the eye. An outbreak of TASS was recognized at an outpatient Surgical center and its affiliated hospital in December 2002. Methods. Medical records of patients who underwent cataract surgery during the outbreak were reviewed, and Surgical team members who participated in the operations were interviewed. Potential causes of TASS were identified and eliminated. Feedwater from autoclave steam generators and steam condensates were analyzed by use of spectroscopy and ion chromatography. Results. During the outbreak, 8 (38%) of 21 cataract operations were complicated by TASS, compared with 2 (0.07%) of 2,713 operations performed from January 1996 through November 2002. Results of an initial investigation suggested that cataract Surgical Equipment may have been contaminated by suboptimal Equipment reprocessing or as a result of personnel changes. The frequency of TASS decreased (1 of 44 cataract operations) after reassignment of personnel and revision of Equipment reprocessing procedures. Further investigation identified the presence of impurities (eg, sulfates, copper, zinc, nickel, and silica) in autoclave steam moisture, which was attributed to improper maintenance of the autoclave steam generator in the outpatient Surgical center. When impurities in autoclave steam moisture were eliminated, no cases of TASS were observed after more than 1,000 cataract operations. Conclusion. Suboptimal reprocessing of cataract Surgical Equipment may evolve over time in busy, multidisciplinary Surgical centers. Clinically significant contamination of Surgical Equipment may result from inappropriate maintenance of steam sterilization systems. Standardization of protocols for reprocessing of cataract Surgical Equipment may prevent outbreaks of TASS and may be of assistance during outbreak investigations.
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Outbreak of toxic anterior segment syndrome following cataract surgery associated with impurities in autoclave steam moisture.
'University of Chicago Press', 2006Co-Authors: Mamalis Nick, Walter C. HellingerAbstract:Journal ArticleBACKGROUND: Toxic anterior segment syndrome (TASS), a complication of cataract surgery, is a sterile inflammation of the anterior chamber of the eye. An outbreak of TASS was recognized at an outpatient Surgical center and its affiliated hospital in December 2002. METHODS: Medical records of patients who underwent cataract surgery during the outbreak were reviewed, and Surgical team members who participated in the operations were interviewed. Potential causes of TASS were identified and eliminated. Feedwater from autoclave steam generators and steam condensates were analyzed by use of spectroscopy and ion chromatography. RESULTS: During the outbreak, 8 (38%) of 21 cataract operations were complicated by TASS, compared with 2 (0.07%) of 2,713 operations performed from January 1996 through November 2002. Results of an initial investigation suggested that cataract Surgical Equipment may have been contaminated by suboptimal Equipment reprocessing or as a result of personnel changes. The frequency of TASS decreased (1 of 44 cataract operations) after reassignment of personnel and revision of Equipment reprocessing procedures. Further investigation identified the presence of impurities (eg, sulfates, copper, zinc, nickel, and silica) in autoclave steam moisture, which was attributed to improper maintenance of the autoclave steam generator in the outpatient Surgical center. When impurities in autoclave steam moisture were eliminated, no cases of TASS were observed after more than 1,000 cataract operations. CONCLUSION: Suboptimal reprocessing of cataract Surgical Equipment may evolve over time in busy, multidisciplinary Surgical centers. Clinically significant contamination of Surgical Equipment may result from inappropriate maintenance of steam sterilization systems. Standardization of protocols for reprocessing of cataract Surgical Equipment may prevent outbreaks of TASS and may be of assistance during outbreak investigations
R M Oosting - One of the best experts on this subject based on the ideXlab platform.
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availability procurement training usage maintenance and complications of electroSurgical units and laparoscopic Equipment in 12 african countries
BJS Open, 2020Co-Authors: R M Oosting, June Madete, Reinou S Groen, L S G L Wauben, Jenny DankelmanAbstract:Background Strategies are needed to increase the availability of Surgical Equipment in low‐ and middle‐income countries (LMICs). This study was undertaken to explore the current availability, procurement, training, usage, maintenance and complications encountered during use of electroSurgical units (ESUs) and laparoscopic Equipment. Methods A survey was conducted among surgeons attending the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA) in December 2017 and the annual meeting of the Surgical Society of Kenya (SSK) in March 2018. Biomedical Equipment technicians (BMETs) were surveyed and maintenance records collected in Kenya between February and March 2018. Results Among 80 participants, there were 59 surgeons from 12 African countries and 21 BMETs from Kenya. Thirty‐six maintenance records were collected. ESUs were available for all COSECSA and SSK surgeons, but only 49 per cent (29 of 59) had access to working laparoscopic Equipment. Reuse of disposable ESU accessories and difficulties obtaining carbon dioxide were identified. More than three‐quarters of surgeons (79 per cent) indicated that maintenance of ESUs was available, but only 59 per cent (16 of 27) confirmed maintenance of laparoscopic Equipment at their centre. Conclusion Despite the availability of Surgical Equipment, significant gaps in access to maintenance were apparent in these LMICs, limiting implementation of open and laparoscopic surgery.
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towards increased global availability of Surgical Equipment
2019Co-Authors: R M OostingAbstract:The need for surgery in low- and middle-income countries (LMICs) is tremendous; more people die from treatable Surgical conditions than from tuberculosis, malaria and HIV put together. A crucial barrier to Surgical care in LMICs is the limited availability of Surgical Equipment, which results in delays and cancellations of surgeries on a daily basis. The overall aim of this thesis is to study the use of Surgical Equipment in LMICs, in order to understand how to increase global availability of Surgical Equipment in the future. One of the strategies that is researched more thoroughly, is the design of context-specific Surgical Equipment. As many areas in Africa feel the burden of limited access to surgery, we have used hospitals in Africa as a case study, with a main focus on Kenya.
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barriers to availability of Surgical Equipment in kenya
Global Clinical Engineering Journal, 2019Co-Authors: R M Oosting, Linda S G L Wauben, Salome W Mwaura, June Madete, Reinou S Groen, Jenny DankelmanAbstract:Background & Objective:The need for surgery is currently not met in Sub-Saharan Africa, requiring both extra workforce and Surgical Equipment. Currently, there is a gap in the availability of Surgical Equipment which, among others, limits the provision of safe surgery. To design strategies to increase availability, the use of Surgical Equipment in this context needs to be understood. This study aims to: 1) identify the different phases Surgical Equipment goes through during its lifespan (i.e. the Surgical Equipment journey) in Kenya, and to 2) identify barriers that are perceived by biomedical Equipment technicians (BMETs). Material & Methods:Seven semi-structured in-depth interview sessions were conducted with a total of 17 BMETs working in Kenya. Participants worked in six different hospitals (four public, one private and one mission). Interviews were conducted between December 2016 and December 2018. Participants were asked to describe or draw the Surgical Equipment journey and describe the perceived barriers during this journey. Results:The Surgical Equipment journey consists of three phases: procurement, usage, and disposal. Stakeholders involved in the Surgical Equipment journey are users, BMETs, procurement officers, local distributors and in case of donations, donation agencies. Bureaucracy during procurement, difficulties to obtain consumables and spare parts (especially for donated Equipment), cleaning with heavy chemicals, and usage in challenging environments were identified as barriers during the Surgical Equipment journey. Conclusion:Sustainable interventions at multiple organisational levels are required to optimize the Surgical Equipment journey in hospitals in Kenya. Different strategies that can be applied in parallel to increase availability of Surgical Equipment in Kenya were identified by the participants in this study: policies on donations, procurement of durable Equipment, more well-trained BMETs and university-trained biomedical engineers, and designs and business models that fit the local use in Kenya and presumably other countries in Sub-Saharan Africa.
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Equipment for essential Surgical care in 9 countries across africa availability barriers and need for novel design
Health technology, 2019Co-Authors: R M Oosting, Linda S G L Wauben, Reinou S Groen, Jenny DankelmanAbstract:Shortages of medical Equipment in low-and-middle income countries (LMICs) have been found by several previous studies that assessed Surgical capacity. To increase Surgical capacity, there is a need to identify the availability of specific types of Surgical Equipment on a local, regional and national level. A survey was conducted among surgeons attending the annual meeting of the College Of Surgeons of East, Central and Southern Africa (COSECSA) in December 2016. General information of the facilities, availability of Surgical Equipment, reasons for limited availability, daily usage of Equipment and Equipment that could benefit from redesign were assessed. Forty-two respondents participated in this study, representing 33 individual healthcare facilities (14 public referrals, 9 public district and 10 private (for-profit and non-profit)). The respondents worked in 9 countries in East, Central, Western and Southern Africa. A deficiency in availability of basic Surgical Equipment was found, especially in public district hospitals. ElectroSurgical units, endoscopes, defibrillators, infusions pumps and electrocardiogram monitors were of limited availability. Reasons indicated for this limited availability were: no need, too costly, no training, no disposables and no repair. Lack of maintenance and old/overused Equipment were identified as major reasons for failure of Equipment. Equipment that could benefit from redesign were for example: electroSurgical units, laparoscopic Equipment and theatre lights. Availability of Surgical Equipment should be increased, especially in public district hospitals. Novel context appropriate redesign that is adapted to fit the context in LMICs could decrease the barriers to availability and to failure of Surgical Equipment.
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roadmap for design of Surgical Equipment for safe surgery worldwide
Global Humanitarian Technology Conference, 2018Co-Authors: R M Oosting, Linda S G L Wauben, June Madete, Jenny Dankelman, Reinou S GroenAbstract:Safe and affordable surgery is not accessible for five billion people when they need it. Multiple Surgical capacity studies have shown that hospitals in low-and-middle income countries do not have complete coverage of basic Surgical Equipment such as, theatre lights, anesthesia machines and electro Surgical units. Currently, almost all Equipment is designed and manufactured with a main focus on the context in high income countries. The context in low-and-middle income countries in which Surgical Equipment is used, differs from high income countries, especially in terms of financial resources and access to maintenance, spare parts and consumables. The aim of this study is to present a roadmap for design of Surgical Equipment for worldwide use. The roadmap consists of four phases: before the start of a design project a clear need for certain Surgical Equipment should be identified (Phase 0). During Phase 1 the context should be researched thoroughly by determining the barriers encountered by patients to Surgical care, the structure of the health care system and if the aspects required for safe surgery are in place. In Phase 2 the implementation strategy and design requirements should be determined and in phase 3 prototyping starts in close interaction with local end-users. We believe that designers should strive for design that is of the same quality and complies with the same safety regulations as Equipment designed for HICs. In this way user and patient safety can be assured in any setting worldwide. And we advocate for Surgical Equipment that fits the context optimally and that will be applicable in comparable settings globally.
Reinou S Groen - One of the best experts on this subject based on the ideXlab platform.
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availability procurement training usage maintenance and complications of electroSurgical units and laparoscopic Equipment in 12 african countries
BJS Open, 2020Co-Authors: R M Oosting, June Madete, Reinou S Groen, L S G L Wauben, Jenny DankelmanAbstract:Background Strategies are needed to increase the availability of Surgical Equipment in low‐ and middle‐income countries (LMICs). This study was undertaken to explore the current availability, procurement, training, usage, maintenance and complications encountered during use of electroSurgical units (ESUs) and laparoscopic Equipment. Methods A survey was conducted among surgeons attending the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA) in December 2017 and the annual meeting of the Surgical Society of Kenya (SSK) in March 2018. Biomedical Equipment technicians (BMETs) were surveyed and maintenance records collected in Kenya between February and March 2018. Results Among 80 participants, there were 59 surgeons from 12 African countries and 21 BMETs from Kenya. Thirty‐six maintenance records were collected. ESUs were available for all COSECSA and SSK surgeons, but only 49 per cent (29 of 59) had access to working laparoscopic Equipment. Reuse of disposable ESU accessories and difficulties obtaining carbon dioxide were identified. More than three‐quarters of surgeons (79 per cent) indicated that maintenance of ESUs was available, but only 59 per cent (16 of 27) confirmed maintenance of laparoscopic Equipment at their centre. Conclusion Despite the availability of Surgical Equipment, significant gaps in access to maintenance were apparent in these LMICs, limiting implementation of open and laparoscopic surgery.
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barriers to availability of Surgical Equipment in kenya
Global Clinical Engineering Journal, 2019Co-Authors: R M Oosting, Linda S G L Wauben, Salome W Mwaura, June Madete, Reinou S Groen, Jenny DankelmanAbstract:Background & Objective:The need for surgery is currently not met in Sub-Saharan Africa, requiring both extra workforce and Surgical Equipment. Currently, there is a gap in the availability of Surgical Equipment which, among others, limits the provision of safe surgery. To design strategies to increase availability, the use of Surgical Equipment in this context needs to be understood. This study aims to: 1) identify the different phases Surgical Equipment goes through during its lifespan (i.e. the Surgical Equipment journey) in Kenya, and to 2) identify barriers that are perceived by biomedical Equipment technicians (BMETs). Material & Methods:Seven semi-structured in-depth interview sessions were conducted with a total of 17 BMETs working in Kenya. Participants worked in six different hospitals (four public, one private and one mission). Interviews were conducted between December 2016 and December 2018. Participants were asked to describe or draw the Surgical Equipment journey and describe the perceived barriers during this journey. Results:The Surgical Equipment journey consists of three phases: procurement, usage, and disposal. Stakeholders involved in the Surgical Equipment journey are users, BMETs, procurement officers, local distributors and in case of donations, donation agencies. Bureaucracy during procurement, difficulties to obtain consumables and spare parts (especially for donated Equipment), cleaning with heavy chemicals, and usage in challenging environments were identified as barriers during the Surgical Equipment journey. Conclusion:Sustainable interventions at multiple organisational levels are required to optimize the Surgical Equipment journey in hospitals in Kenya. Different strategies that can be applied in parallel to increase availability of Surgical Equipment in Kenya were identified by the participants in this study: policies on donations, procurement of durable Equipment, more well-trained BMETs and university-trained biomedical engineers, and designs and business models that fit the local use in Kenya and presumably other countries in Sub-Saharan Africa.
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Equipment for essential Surgical care in 9 countries across africa availability barriers and need for novel design
Health technology, 2019Co-Authors: R M Oosting, Linda S G L Wauben, Reinou S Groen, Jenny DankelmanAbstract:Shortages of medical Equipment in low-and-middle income countries (LMICs) have been found by several previous studies that assessed Surgical capacity. To increase Surgical capacity, there is a need to identify the availability of specific types of Surgical Equipment on a local, regional and national level. A survey was conducted among surgeons attending the annual meeting of the College Of Surgeons of East, Central and Southern Africa (COSECSA) in December 2016. General information of the facilities, availability of Surgical Equipment, reasons for limited availability, daily usage of Equipment and Equipment that could benefit from redesign were assessed. Forty-two respondents participated in this study, representing 33 individual healthcare facilities (14 public referrals, 9 public district and 10 private (for-profit and non-profit)). The respondents worked in 9 countries in East, Central, Western and Southern Africa. A deficiency in availability of basic Surgical Equipment was found, especially in public district hospitals. ElectroSurgical units, endoscopes, defibrillators, infusions pumps and electrocardiogram monitors were of limited availability. Reasons indicated for this limited availability were: no need, too costly, no training, no disposables and no repair. Lack of maintenance and old/overused Equipment were identified as major reasons for failure of Equipment. Equipment that could benefit from redesign were for example: electroSurgical units, laparoscopic Equipment and theatre lights. Availability of Surgical Equipment should be increased, especially in public district hospitals. Novel context appropriate redesign that is adapted to fit the context in LMICs could decrease the barriers to availability and to failure of Surgical Equipment.
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roadmap for design of Surgical Equipment for safe surgery worldwide
Global Humanitarian Technology Conference, 2018Co-Authors: R M Oosting, Linda S G L Wauben, June Madete, Jenny Dankelman, Reinou S GroenAbstract:Safe and affordable surgery is not accessible for five billion people when they need it. Multiple Surgical capacity studies have shown that hospitals in low-and-middle income countries do not have complete coverage of basic Surgical Equipment such as, theatre lights, anesthesia machines and electro Surgical units. Currently, almost all Equipment is designed and manufactured with a main focus on the context in high income countries. The context in low-and-middle income countries in which Surgical Equipment is used, differs from high income countries, especially in terms of financial resources and access to maintenance, spare parts and consumables. The aim of this study is to present a roadmap for design of Surgical Equipment for worldwide use. The roadmap consists of four phases: before the start of a design project a clear need for certain Surgical Equipment should be identified (Phase 0). During Phase 1 the context should be researched thoroughly by determining the barriers encountered by patients to Surgical care, the structure of the health care system and if the aspects required for safe surgery are in place. In Phase 2 the implementation strategy and design requirements should be determined and in phase 3 prototyping starts in close interaction with local end-users. We believe that designers should strive for design that is of the same quality and complies with the same safety regulations as Equipment designed for HICs. In this way user and patient safety can be assured in any setting worldwide. And we advocate for Surgical Equipment that fits the context optimally and that will be applicable in comparable settings globally.
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GHTC - Roadmap for Design of Surgical Equipment for Safe Surgery Worldwide
2018 IEEE Global Humanitarian Technology Conference (GHTC), 2018Co-Authors: R M Oosting, Linda S G L Wauben, June Madete, Jenny Dankelman, Reinou S GroenAbstract:Safe and affordable surgery is not accessible for five billion people when they need it. Multiple Surgical capacity studies have shown that hospitals in low-and-middle income countries do not have complete coverage of basic Surgical Equipment such as, theatre lights, anesthesia machines and electro Surgical units. Currently, almost all Equipment is designed and manufactured with a main focus on the context in high income countries. The context in low-and-middle income countries in which Surgical Equipment is used, differs from high income countries, especially in terms of financial resources and access to maintenance, spare parts and consumables. The aim of this study is to present a roadmap for design of Surgical Equipment for worldwide use. The roadmap consists of four phases: before the start of a design project a clear need for certain Surgical Equipment should be identified (Phase 0). During Phase 1 the context should be researched thoroughly by determining the barriers encountered by patients to Surgical care, the structure of the health care system and if the aspects required for safe surgery are in place. In Phase 2 the implementation strategy and design requirements should be determined and in phase 3 prototyping starts in close interaction with local end-users. We believe that designers should strive for design that is of the same quality and complies with the same safety regulations as Equipment designed for HICs. In this way user and patient safety can be assured in any setting worldwide. And we advocate for Surgical Equipment that fits the context optimally and that will be applicable in comparable settings globally.
Jenny Dankelman - One of the best experts on this subject based on the ideXlab platform.
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availability procurement training usage maintenance and complications of electroSurgical units and laparoscopic Equipment in 12 african countries
BJS Open, 2020Co-Authors: R M Oosting, June Madete, Reinou S Groen, L S G L Wauben, Jenny DankelmanAbstract:Background Strategies are needed to increase the availability of Surgical Equipment in low‐ and middle‐income countries (LMICs). This study was undertaken to explore the current availability, procurement, training, usage, maintenance and complications encountered during use of electroSurgical units (ESUs) and laparoscopic Equipment. Methods A survey was conducted among surgeons attending the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA) in December 2017 and the annual meeting of the Surgical Society of Kenya (SSK) in March 2018. Biomedical Equipment technicians (BMETs) were surveyed and maintenance records collected in Kenya between February and March 2018. Results Among 80 participants, there were 59 surgeons from 12 African countries and 21 BMETs from Kenya. Thirty‐six maintenance records were collected. ESUs were available for all COSECSA and SSK surgeons, but only 49 per cent (29 of 59) had access to working laparoscopic Equipment. Reuse of disposable ESU accessories and difficulties obtaining carbon dioxide were identified. More than three‐quarters of surgeons (79 per cent) indicated that maintenance of ESUs was available, but only 59 per cent (16 of 27) confirmed maintenance of laparoscopic Equipment at their centre. Conclusion Despite the availability of Surgical Equipment, significant gaps in access to maintenance were apparent in these LMICs, limiting implementation of open and laparoscopic surgery.
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barriers to availability of Surgical Equipment in kenya
Global Clinical Engineering Journal, 2019Co-Authors: R M Oosting, Linda S G L Wauben, Salome W Mwaura, June Madete, Reinou S Groen, Jenny DankelmanAbstract:Background & Objective:The need for surgery is currently not met in Sub-Saharan Africa, requiring both extra workforce and Surgical Equipment. Currently, there is a gap in the availability of Surgical Equipment which, among others, limits the provision of safe surgery. To design strategies to increase availability, the use of Surgical Equipment in this context needs to be understood. This study aims to: 1) identify the different phases Surgical Equipment goes through during its lifespan (i.e. the Surgical Equipment journey) in Kenya, and to 2) identify barriers that are perceived by biomedical Equipment technicians (BMETs). Material & Methods:Seven semi-structured in-depth interview sessions were conducted with a total of 17 BMETs working in Kenya. Participants worked in six different hospitals (four public, one private and one mission). Interviews were conducted between December 2016 and December 2018. Participants were asked to describe or draw the Surgical Equipment journey and describe the perceived barriers during this journey. Results:The Surgical Equipment journey consists of three phases: procurement, usage, and disposal. Stakeholders involved in the Surgical Equipment journey are users, BMETs, procurement officers, local distributors and in case of donations, donation agencies. Bureaucracy during procurement, difficulties to obtain consumables and spare parts (especially for donated Equipment), cleaning with heavy chemicals, and usage in challenging environments were identified as barriers during the Surgical Equipment journey. Conclusion:Sustainable interventions at multiple organisational levels are required to optimize the Surgical Equipment journey in hospitals in Kenya. Different strategies that can be applied in parallel to increase availability of Surgical Equipment in Kenya were identified by the participants in this study: policies on donations, procurement of durable Equipment, more well-trained BMETs and university-trained biomedical engineers, and designs and business models that fit the local use in Kenya and presumably other countries in Sub-Saharan Africa.
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Equipment for essential Surgical care in 9 countries across africa availability barriers and need for novel design
Health technology, 2019Co-Authors: R M Oosting, Linda S G L Wauben, Reinou S Groen, Jenny DankelmanAbstract:Shortages of medical Equipment in low-and-middle income countries (LMICs) have been found by several previous studies that assessed Surgical capacity. To increase Surgical capacity, there is a need to identify the availability of specific types of Surgical Equipment on a local, regional and national level. A survey was conducted among surgeons attending the annual meeting of the College Of Surgeons of East, Central and Southern Africa (COSECSA) in December 2016. General information of the facilities, availability of Surgical Equipment, reasons for limited availability, daily usage of Equipment and Equipment that could benefit from redesign were assessed. Forty-two respondents participated in this study, representing 33 individual healthcare facilities (14 public referrals, 9 public district and 10 private (for-profit and non-profit)). The respondents worked in 9 countries in East, Central, Western and Southern Africa. A deficiency in availability of basic Surgical Equipment was found, especially in public district hospitals. ElectroSurgical units, endoscopes, defibrillators, infusions pumps and electrocardiogram monitors were of limited availability. Reasons indicated for this limited availability were: no need, too costly, no training, no disposables and no repair. Lack of maintenance and old/overused Equipment were identified as major reasons for failure of Equipment. Equipment that could benefit from redesign were for example: electroSurgical units, laparoscopic Equipment and theatre lights. Availability of Surgical Equipment should be increased, especially in public district hospitals. Novel context appropriate redesign that is adapted to fit the context in LMICs could decrease the barriers to availability and to failure of Surgical Equipment.
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roadmap for design of Surgical Equipment for safe surgery worldwide
Global Humanitarian Technology Conference, 2018Co-Authors: R M Oosting, Linda S G L Wauben, June Madete, Jenny Dankelman, Reinou S GroenAbstract:Safe and affordable surgery is not accessible for five billion people when they need it. Multiple Surgical capacity studies have shown that hospitals in low-and-middle income countries do not have complete coverage of basic Surgical Equipment such as, theatre lights, anesthesia machines and electro Surgical units. Currently, almost all Equipment is designed and manufactured with a main focus on the context in high income countries. The context in low-and-middle income countries in which Surgical Equipment is used, differs from high income countries, especially in terms of financial resources and access to maintenance, spare parts and consumables. The aim of this study is to present a roadmap for design of Surgical Equipment for worldwide use. The roadmap consists of four phases: before the start of a design project a clear need for certain Surgical Equipment should be identified (Phase 0). During Phase 1 the context should be researched thoroughly by determining the barriers encountered by patients to Surgical care, the structure of the health care system and if the aspects required for safe surgery are in place. In Phase 2 the implementation strategy and design requirements should be determined and in phase 3 prototyping starts in close interaction with local end-users. We believe that designers should strive for design that is of the same quality and complies with the same safety regulations as Equipment designed for HICs. In this way user and patient safety can be assured in any setting worldwide. And we advocate for Surgical Equipment that fits the context optimally and that will be applicable in comparable settings globally.
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GHTC - Roadmap for Design of Surgical Equipment for Safe Surgery Worldwide
2018 IEEE Global Humanitarian Technology Conference (GHTC), 2018Co-Authors: R M Oosting, Linda S G L Wauben, June Madete, Jenny Dankelman, Reinou S GroenAbstract:Safe and affordable surgery is not accessible for five billion people when they need it. Multiple Surgical capacity studies have shown that hospitals in low-and-middle income countries do not have complete coverage of basic Surgical Equipment such as, theatre lights, anesthesia machines and electro Surgical units. Currently, almost all Equipment is designed and manufactured with a main focus on the context in high income countries. The context in low-and-middle income countries in which Surgical Equipment is used, differs from high income countries, especially in terms of financial resources and access to maintenance, spare parts and consumables. The aim of this study is to present a roadmap for design of Surgical Equipment for worldwide use. The roadmap consists of four phases: before the start of a design project a clear need for certain Surgical Equipment should be identified (Phase 0). During Phase 1 the context should be researched thoroughly by determining the barriers encountered by patients to Surgical care, the structure of the health care system and if the aspects required for safe surgery are in place. In Phase 2 the implementation strategy and design requirements should be determined and in phase 3 prototyping starts in close interaction with local end-users. We believe that designers should strive for design that is of the same quality and complies with the same safety regulations as Equipment designed for HICs. In this way user and patient safety can be assured in any setting worldwide. And we advocate for Surgical Equipment that fits the context optimally and that will be applicable in comparable settings globally.