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1
Ben-Zvi, Noa. "(OR)² : operations research applied to operating room supply chain". Thesis, Massachusetts Institute of Technology, 2014. http://hdl.handle.net/1721.1/91096.
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Thesis: S.M., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2014. In conjunction with the Leaders for Global Operations Program at MIT.Thesis: M.B.A., Massachusetts Institute of Technology, Sloan School of Management, 2014. In conjunction with the Leaders for Global Operations Program at MIT.
Cataloged from PDF version of thesis.
Includes bibliographical references (page 63).
Massachusetts General Hospital (MGH) is ranked as the top hospital in New England and second nation-wide. It is also the largest hospital in New England; it uses an average of 58 operating rooms, where approximately 150 surgical procedures are performed daily. Management of surgical supplies is a critical component of the processes supporting this infrastructure. Specifically, ensuring the right equipment and supplies are available at the right time is critical for the efficiency and quality outcomes of each of the procedures. The materials management group handles over 10,000 unique items, purchased from more than 400 vendors. The majority (60-70%) of disposable supplies are ordered through Owens & Minor, a medical and surgical supplies distributor. The supplies are stored in multiple locations throughout the hospital, including two central locations as well as carts and cabinets on the surgical floors and in the operating rooms. The work described in this thesis focuses on the inventory management of disposable surgical supplies, where the current system design has inefficiencies in the inventory levels and location of items. Using a data-driven approach, based on historical demand, we calculate base stock levels by item that maintain three days of inventory at a 99 percent service level. In addition, we suggest a methodology to support decisions on inventory locations of the different items. Implementation of the recommended changes is estimated to result in savings of 30-40% in inventory levels (and space), corresponding to a one time saving of $700,000-$900,000, depending on the implementation scenario. In addition, the reduction in inventory levels can be translated to future savings in inventory holding costs at an estimated 40% rate, leading to a saving of roughly $300,000 annually.
by Noa Ben-Zvi.
S.M.
M.B.A.
2
Eakin, Sherri. "Operating room nurses and surgical technologists perceptions of job satisfaction in the operating room environment". Thesis, University of Phoenix, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10024192.
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The predicted future operating room nurse and surgical technologist shortages may have significant implications for the healthcare industry. Improving the job satisfaction of operating room personnel could promote retention and provide adequate staffing in operating rooms. The job satisfaction of operating room nurses and surgical technologists can result in positive or negative work environments. The purpose of the qualitative phenomenological study was to explore the perceptions of job satisfaction of operating room nurses and surgical technologists to discover how job satisfaction influences the intent to leave or remain in the work environment of the operating room. A purposive selection was made of 12 registered nurses and 12 surgical technologists who had varying degrees of experience in the healthcare field, and were working part time or full time in the operating room of a pediatric medical center in North, Texas. Interviews were audio-recorded and the seven steps were used from Moustakas van Kaam analysis to reveal themes and patterns from the research data. Six themes emerged from the research study that included teamwork, recognition from surgeon, working with pediatric patients and their families, staff appreciation, work environment, and executive leadership. Based on the findings, further research is needed to ascertain strategies that would improve operating room registered nurses and surgical technologists’ job satisfaction and retention.
3
Parker, Sarah Henrickson. "Surgeons' leadership in the operating room". Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=174680.
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The operating room (OR) is an area of particularly high risk for patients, due to technical and non-technical issues. Research in other high-risk industries has shown that leadership can impact safety and performance of work teams. As the leader of the surgical team, surgeons must demonstrate leadership along with technical excellence, to optimize performance and maximize patient safety in the OR. This thesis investigated surgeons’ leadership in the intraoperative period. A review of the surgical literature revealed ten empirical articles examining surgeon leadership. Of these, two articles linked leadership was an outcome measure. A preliminary taxonomy that included seven elements of leadership was developed based on definitions of leadership from the literature. To further investigate intraoperative leadership, observations (n=29) were conducted in three hospitals in Scotland across different types of surgery. Leadership was described in detail according to the leadership elements. Surgeons engaged in significantly more leadership during more complex operations. Ten focus groups with different members of the OR team were conducted to finalize the taxonomy. The final taxonomy, the Surgeons’ Leadership Inventory (SLI), was revised to include eight elements: maintaining standards making decisions, managing resources, directing, training, communicating, supporting others, and coping with pressure. The SLI was used with adequate reliability to code videos (n=29) of live operations. Elements of surgeons’ leadership differed before and after the surgical point of no return. Analysis revealed differences in training and supporting others behaviours in cases with an unexpected event. The element coping with pressure was significantly related to intraoperative blood loss. Surgeons’ intraoperative leadership was found to be reactive, situation based, and often transactional in nature. This thesis provides a first step in identifying the important behaviours and a basis on which improving surgeons’ intraoperative leadership may be made.
4
ShahabiKargar, Zahra. "Intelligent Scheduling for Hospital Operating Rooms". Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367615.
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Scheduling problems emerge almost everywhere in real world situations. Efficient scheduling of resources in dynamic complex real world environments continues to pose a significant research challenge. Every real world problem has its own idiosyn- crasies, and environments in the real world are often more complicated. In real world dynamic environments, inevitable and unpredictable real-time events often force a change in scheduled plans. Despite this, most current approaches have been focused on solving simplified scheduling models assuming that all problem characteristics are known in advance.
As the hospital’s largest revenue and cost centre, operating rooms are of pivotal importance to hospitals. Any improvement of surgery delivery systems is particularly important for hospitals. With healthcare starting to buckle under the pressures of growing demand and encumbered resources, improving operating room scheduling to deliver a significant improvement in utilisation of this overburdened resource is more important than ever. Motivated with this need, this dissertation describes our efforts to deliver significant improvements to operating room scheduling processes, particularly in Australian public hospitals.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Institute for Integrated and Intelligent Systems
Science, Environment, Engineering and Technology
Full Text
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Grange, Sébastien. "M/ORIS - Medical / Operating Room Interaction System /". Lausanne : EPFL, 2007. http://library.epfl.ch/theses/?nr=3798.
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Thèse Ecole polytechnique fédérale de Lausanne EPFL, no 3798 (2007), Faculté des sciences et techniques de l'ingénieur STI, Section de microtechnique, Institut de production et robotique IPR (Laboratoire de systèmes robotiques 2 LSRO2). Dir.: Roland Siegwart, Charles Baur.
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Clapham, Michael Charles Cornell. "Learning to teach in the operating room". Thesis, University of Birmingham, 2008. http://etheses.bham.ac.uk//id/eprint/186/.
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The focus of this study is how anaesthetic trainees teach and learn to teach within the operating room (OR) and how this might be improved. Methods of study included interviews, action learning groups (ALG), and a questionnaire. The data were collected within the confines of a case study drawing on the principles of action research. The anaesthetic trainees taught mainly in the OR and interacted with three types of learner, defined by their relation to the anaesthetic community of practice. The primary responsibility for patient safety presented a significant challenge to OR teaching and required the clinicianteacher to balance the needs of the patient and the learner. The ALG acted as an effective educational initiative for anaesthetic trainees to enhance and develop good educational practice in the OR. The experiences of a group surgical trainees lent support to the wider generalisability of the use of ALGs. The survey of 36 anaesthetic and surgical trainees confirmed that the OR was a good place to learn although teaching was challenging and patient safety an issue. Results are distilled into a new model which places the patient at the centre of teaching and learning in the OR.
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Neveling, Christoffel Hermanus. "Battlefords Union Hospital operating room suite efficiency review". Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/883.
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Thesis (MBA (Business Management))--University of Stellenbosch, 2007.ENGLISH ABSTRACT: Given the increase in the cost of health care, economic considerations have drawn more and more interest over the last decade. Facilities are faced with the challenge to reduce costs while maintaining productivity. The Operating Room (OR) represents a significant opportunity to reduce expenses and improve efficiency. With the development of ambulatory or day surgery, minimally invasive procedures and the decline in admissions to hospitals the management of the OR suite needs re-evaluation. The Battlefords Union Hospital has a four room OR suite that performs a mixture of both inhospital and day surgeries. The current OR suite efficiency is determined by its adherence to the annual budget. A literature study was conducted with the focus on OR efficiency and in particular Patient Outcome and OR Management. Other issues included Perioperative Information systems and OR design. A survey was conducted in the OR suite and responses obtained from OR staff were evaluated. The survey included questions on patient experiences, procedural times, case scheduling, support, communication, quality measures and OR efficiency. The goals of this project was not to do an extensive statistical analysis of OR data. A limited study of OR suite data was presented to highlight relevant OR efficiency indicators. A summary of the findings and recommendations for improvement of the Battlefords Union Hospital OR suite’s efficiency, concludes the report.
AFIKAANSE OPSOMMING: Na aanleiding van die verhoging in koste van gesondheidsorg die laaste dekade, is ekonomiese aspekte meer op die voorgrond. Inrigtings word deur uitdagings in die gesig gestaar om kostes te verminder, terwyl produktiwiteit gehandhaaf moet word. Die operasie suite bied ‘n aansienlike geleentheid om kostes te verminder en effektiwiteit te verhoog. Met die ontwikkeling van dagchirurgie, “minimal invasive” prosedures en die afname in hospitaal opnames, behoort die bestuur van operasie suites herevalueer te word. Die Battlefords Union Hospitaal het ‘n vier teater operasie suite waar ‘n verskeidenheid van dagchirurgie en in-hospitaal prosedures uitgevoer word. Die operasie suite se effektiwiteit word huidiglik slegs gemeet aan die mate van hoe dit binne die jaarlikse begroting bly. ‘n Literatuurstudie is uitgevoer met die fokus op operasie suite effektiwiteit, met die klem op pasient uitkoms en operasie suite bestuur. Ander items wat ook ondersoek is, sluit in perioperatiewe informasie stelsels en teater ontwerp. ‘n Empiriese studie, gebaseer op ‘n vraelys, is uitgevoer onder die staflede van die operasie suite by die Battlefords Union Hopitaal. Die vraelys het vrae ingesluit oor pasient ervarings, prosedure tye, geval skedulering, kommunikasie, kwaliteitsversekering en operasie suite effektiwiteit. Die doel van die projek was nie om ‘n uitgebreide statistiese analise van die operasie suite data te doen nie. 'n Beperkte studie van die beskikbare data is gedoen en relevante effektiwiteits indikators is uitgewys. Die verslag word afgeëindig deur bevindinge, gevolgtrekkings en aanbevelings oor hoe die Battlefords Union Hospitaal die operasie suite se effektiwiteit moontlik kan verhoog.
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Davies, Samuel Ingraham 1980. "Machine learning at the operating room of the future : a comparison of machine learning techniques applied to operating room scheduling". Thesis, Massachusetts Institute of Technology, 2004. http://hdl.handle.net/1721.1/28379.
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Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2004.Includes bibliographical references (leaves 48-50).
The quality of an operating room schedule is determined by the accuracy of the surgery duration estimation used. State of the art estimation algorithms consider only three surgery variables-procedure type, surgeon identity, and date of surgery-to predict the length of surgeries. We show that if we can take advantage of a richer set of available information, we can significantly improve estimation accuracy. Additional recorded (but unused) variables include patient age, gender, and morbidity, anesthesiologist identity, and surgery location. We implement and compare the accuracy of four standard machine learning algorithms that take advantage of this richer data set: linear regression, nearest neighbors, regression trees, and support vector regression. We conclude that additional variables can improve the accuracy estimate by as much as 20%. Finally, we discuss the implementation challenges and future work necessary to make machine learning techniques available to the data analyst concerned with implementation. Portions of this work are sponsored by the U.S. Dept. of the Army, under DAMD 17-02- 2-0006. The information does not necessarily reflect the position of the government, and no official endorsement should be inferred.
by Samuel Ingraham Davies.
M.Eng.
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Gillespie, Brigid Mary, i N/A. "The Predictors of Resilience in Operating Room Nurses". Griffith University. School of Nursing and Midwifery, 2007. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20070824.123750.
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The nursing workforce has experienced considerable change during the previous decade, resulting in a chronic shortage of nurses. Issues such as economic rationalism, increased workloads, changes in nursing education and the advancing age of the current nursing workforce are the chief contributors to this shortage (Australian Institute of Health & Welfare, 2005b; Buerhaus, Staiger, & Auerbach, 2000b). Operating room (OR) nursing is a primary specialty area that has been especially affected by rising nurse attrition and a reduction in nurse recruitment (Australian College of Operating Room Nurses, 2003; Australian Health Workforce Advisory Committee, 2002). Accordingly, the loss of skilled nurses from the OR specialty compounds the negative effects on morale for those who remain in the environment, as they struggle to provide safe patient care while concomitantly being responsible for the clinical development of neophyte and inexperienced nurses (Australian Health Workforce Advisory Committee, 2002; Arndt, 1998). In the midst of working in the OR environs where the nature of the associated stressors is unique, resilient qualities may assist nurses to meet and overcome these challenges. If there is to be a continued nursing presence in the OR, it is essential that nurses be given the opportunity to develop resilience. At this time when nurse retention rates are continuing to decline steadily, there is a compelling need to identify and describe the relationship between resilience and its predictors in the context of the OR. To date, little is known about predictors of resilience and their potential to ameliorate the effects of workplace stress in the OR. The overall purpose of this study was to identify and describe the predictors of resilience in OR nurses. A literature review and concept analysis of resilience was initially conducted. Hope, self-efficacy, coping and personal characteristics were identified as defining characteristics of resilience. Next, the research was conducted as a mixed method phased study that was underpinned by the pragmatist paradigm, and employed a sequenced combination of qualitative followed by quantitative inquiry (Morgan, 1998). The first phase used a mini-ethnography to identify and describe the components of workplace culture in an OR in relation to their potential impact on nurses ability to adapt in this culture. A triangulated approach was used involving participant observation, a reflective journal, field notes and interviews. This phase revealed that competence, knowledge, collaboration, peer support and the ability to manage challenges were central components of OR workplace culture. From these categories, three themes were abstracted and subsequently developed into constructs that were measured and validated in the larger second phase. The second phase used a predictive correlation survey to describe empirically the relationship between resilience and its hypothesised predictors in a systematic random national sample of nurses who were members of the Australian College of Operating Room Nurses (ACORN), and a combined sample of hospital nurses purposively drawn from two similar hospital sites. The survey included scales measuring perceived competence, collaboration, managing stress, self-efficacy, hope, coping, and resilience, as well as gathering information about the demographic characteristics of nurse respondents. Out of a total potential sample of 1,730 OR nurses, the overall response rate was 51.7% (n = 896). Differences between the ACORN and hospital samples were found in age, years of experience, education and years of employment; therefore, the national and hospital samples findings were analysed separately. Five independent variables hope, self-efficacy, coping, managing stress and competence predicted resilience in the larger sample of ACORN respondents (n = 772). For the substantially smaller sample of hospital respondents (n = 124), hope, self-efficacy and managing stress predicted resilience. Given that the smaller hospital sample resulted in a similar model, this consistency lends strength and weight to the revised resilience model. Over 60% of the variance in resilience was explained by the independent variables in each model. Given the dearth of literature describing the efficacy of resilience in ameliorating stress in OR contexts, the results of this study have extended the theoretical application of the resilience concept to include a nursing context. There is a need to implement resilience-building strategies that address the culture of the OR, both at the departmental and organisational levels. Strategies that provide a supportive workplace environment in relation to goal-orientation, the provision of stress management and education programs, and strategies that facilitate cultural assimilation may improve resilience, and hence retention and recruitment rates in the OR. The findings of this study support the need for further research not only to test the stability of the proposed model among other groups of nurses but also to explore further predictors of resilience in the OR setting.
10
Al-Ojaimi, Abdulkarim. "Evidence based models for evaluating operating room performance". Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/47338/.
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The operating room (OR) within a hospital environment is one of the most expensive functional areas, yet the use of the OR also provides hospitals with an essential source of income. However, at present, there are variations on how to evaluate the performance of ORs, since there is no clear and full explanation of the concept and methods used for evaluation. The overall aim of this thesis is to develop an evidence based Operating Room Assessment Framework (ORAF) to evaluate Operating Room performance with clear and complete guidelines that can be used by operating room managers, directors or any other medical professionals to evaluate operating room performance, determine OR planning and scheduling efficiency, OR workload and OR utilization. The resulting Operating Room Assessment Framework will assist targeted healthcare professionals in their quest to evaluate, monitor and improve overall Operating Room efficiency. The OR management systems of eight tertiary and teaching hospitals in three countries (Japan, Canada and Saudi Arabia) have been examined from 2010 to 2012, which include more than 98,500 procedures. The Operating Room Assessment Framework (ORAF) involves three important elements of Operating Room performance, namely: OR scheduling level, the type of OR workload, and OR utilization. These elements can simply be read to reach the end result, which includes three types of scheduling levels: under scheduling, ideal scheduling and over scheduling; five types of OR workload: OR total workload (the gross workload), OR actual workload, over workload, unnecessary workload and unexpected workload; and three types of OR utilization: underutilization, ideal utilization, and 100% utilization with over workload. Through the validation process in different hospital contexts, the ORAF has proven its ability to perform satisfactorily, with accuracy, in line within the research’s objectives.
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Sadeghian, Parastoo. "A new generation of hospital operating room ventilation". Licentiate thesis, KTH, Hållbara byggnader, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-284542.
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Surgical site infection is responsible for 38 percent of reported infections after surgery. This infection increases mortality and treatment costs, and prolongs the hospitalization of patients. Bacteria-carrying particles are the main cause of surgical site infection and one of the main sources of these particles is skin fragments released from the surgical personnel during an ongoing surgery. Ventilation systems reduce the concentration of bacteria-carrying particles by supplying clean air in the operating room. The performance of operating room ventilation systems is affected by internal disruptions such as medical equipment, surgical lamps, number of staff and their behaviour during the surgery. Using computational fluid dynamics, this thesis investigates the airflow behaviour and distribution of the contamination in the operating room under the presence of various internal disruptions. In this regard, three common ventilation systems are considered: laminar airflow, turbulent mixing and temperature-controlled airflow ventilations. This study tries to overcome the weaknesses of the ventilation systems by providing sustainable solutions and continuously being in contact with design companies. It is common to use warming blankets to prevent reduction in the core body temperature of the patient during major surgeries. However, there is a major concern that these blankets disrupt the supplied airflow, which results in rising contaminant concentration. Most of the studies about warming blankets are clinical works and it is still not clear whether or not these blankets should be used. The results of the present study show that using warming blankets had no impact on increase of contamination level at the surgical zone. However, one common type of warming blanket – a forced-air warming blanket – can considerably increase the concentration of bacteria-carrying particles at the wound area if it becomes contaminated. The simulated results of the airflow field and particle tracking showed that the laminar airflow ventilation system was disturbed more easily by the local heat loads than overall heat loads in the operating room. Surgical lamps are considered as an obstacle in the supplied airflow path. These lamps create a stagnant area above the operating table and increase the contamination level. In this regard, a novel design of surgical lamp, a fan-mounted surgical lamp, was introduced to operating rooms.This device was used in the operating rooms equipped with laminar airflow and mixing ventilation system. The simulated results revealed that this lamp significantly reduced the contamination level at the operating table. Visualization techniques were adopted to teach and improve the understanding of surgical personnel about transmission of contaminated particles in operating rooms. Here, a virtual and augmented reality interface was used to visualize the impact of differences in ventilation principle, surgical staff constellation and work practice.Infektioner relaterade till kirurgiskt ingrepp utgör 38 % av rapporterade infektioner efter operation. Dessa infektioner ökar dödligheten och behandlingskostnaderna samt förlänger patienternas sjukhusvistelse. Bakteriebärande partiklar är den främsta orsaken till infektion vid kirurgi. Huvudkällan till dessa partiklar är hudfragment som frigörs från kirurgisk personal under en pågående operation. Genom att tillföra ren luft via ventilationssystemet kan koncentrationen av baktebärande partiklar i operationssalen minskas. Ventilationssystemets förmåga att ventilera salen påverkas av föremål som stör luftströmmen, som exempel medicinsk utrustning, kirurgiska lampor samt av närvarande personal och deras beteende under operationen. Med avancerade numeriska strömningsberäkningar undersöks i denna avhandling luftflöden och fördelningen av föroreningar i operationssalen under inverkan av sådana störningar. Tre olika ventilationssystem inkluderas. Ett för laminärt luftflöde, ett för turbulent omblandning och ett för temperaturreglerad luftströmning. I studien kartläggs ventilationssystemens funktion och relevansen prövas i ett kontinuerligt samarbete med tillverkande industri. Användning av värmefiltar förekommer under större operationer för att hålla patientens kroppstemperatur stabil. Det finns emellertid en stor oro för att dessa filtar stör det tillförda luftflödet och därmed ökar föroreningsnivån. En vanlig typ av värmefilt med forcerad varmluft kan om den är förorenad avsevärt öka koncentrationen av bakteriebärande partiklar i sårområdet. De flesta undersökningar om värmande filtar är kliniska studier och det är fortfarande inte helt klarlagt i vilken mån och hur dessa filtar skall användas. Denna studie visar emellertid att användning av värmefiltar inte påverkar föroreningsnivån i den kirurgiska zonen. Gjorda datorsimuleringar av luftflödesfältet och partikelspårning visar att det laminära ventilationsflödet lättare störs av lokala värmebelastningarna än av generella värmebelastningar i operationssalen. Kirurgiska lampor betraktas som hinder i en planerad luftflödesväg. Lampor kan skapa en stillastående luftmassa ovanför operationsbordet och därmed öka föroreningsnivån. För detta introduceras en ny design av kirurgisk lampa, en fläktmonterad kirurgisk lampa för operationsrum, utrustade med laminärt luftflöde och omblandning. Simulerade resultat visar att denna nya kirurgiska lampa signifikant minskar föroreningsnivån vid operationsbordet. Visualiseringsteknik användes i denna studie för att förbättra förståelsen hos kirurgisk personal om hur förorenade partiklar kan spridas i operationssalen. Med ett virtuellt och förstärkt gränssnitt visualiserades föroreningshalter i rumsluften då olika typer av ventilationssystem användes. Visualiseringen visar också hur kirurgigruppens storlek och arbetsställning under operation påverkar spridningen av föroreningar.
QC 20201103
12
Stevenson, Tyler C. "Experimental investigation of hospital operating room air distribution". Thesis, Atlanta, Ga. : Georgia Institute of Technology, 2008. http://hdl.handle.net/1853/22574.
Pełny tekst źródła
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Gillespie, Brigid Mary. "The Predictors of Resilience in Operating Room Nurses". Thesis, Griffith University, 2007. http://hdl.handle.net/10072/365391.
Pełny tekst źródłaStreszczenie:
The nursing workforce has experienced considerable change during the previous decade, resulting in a chronic shortage of nurses. Issues such as economic rationalism, increased workloads, changes in nursing education and the advancing age of the current nursing workforce are the chief contributors to this shortage (Australian Institute of Health & Welfare, 2005b; Buerhaus, Staiger, & Auerbach, 2000b). Operating room (OR) nursing is a primary specialty area that has been especially affected by rising nurse attrition and a reduction in nurse recruitment (Australian College of Operating Room Nurses, 2003; Australian Health Workforce Advisory Committee, 2002). Accordingly, the loss of skilled nurses from the OR specialty compounds the negative effects on morale for those who remain in the environment, as they struggle to provide safe patient care while concomitantly being responsible for the clinical development of neophyte and inexperienced nurses (Australian Health Workforce Advisory Committee, 2002; Arndt, 1998). In the midst of working in the OR environs where the nature of the associated stressors is unique, resilient qualities may assist nurses to meet and overcome these challenges. If there is to be a continued nursing presence in the OR, it is essential that nurses be given the opportunity to develop resilience. At this time when nurse retention rates are continuing to decline steadily, there is a compelling need to identify and describe the relationship between resilience and its predictors in the context of the OR. To date, little is known about predictors of resilience and their potential to ameliorate the effects of workplace stress in the OR. The overall purpose of this study was to identify and describe the predictors of resilience in OR nurses. A literature review and concept analysis of resilience was initially conducted. Hope, self-efficacy, coping and personal characteristics were identified as defining characteristics of resilience. Next, the research was conducted as a mixed method phased study that was underpinned by the pragmatist paradigm, and employed a sequenced combination of qualitative followed by quantitative inquiry (Morgan, 1998). The first phase used a mini-ethnography to identify and describe the components of workplace culture in an OR in relation to their potential impact on nurses’ ability to adapt in this culture. A triangulated approach was used involving participant observation, a reflective journal, field notes and interviews. This phase revealed that competence, knowledge, collaboration, peer support and the ability to manage challenges were central components of OR workplace culture. From these categories, three themes were abstracted and subsequently developed into constructs that were measured and validated in the larger second phase. The second phase used a predictive correlation survey to describe empirically the relationship between resilience and its hypothesised predictors in a systematic random national sample of nurses who were members of the Australian College of Operating Room Nurses (ACORN), and a combined sample of hospital nurses purposively drawn from two similar hospital sites. The survey included scales measuring perceived competence, collaboration, managing stress, self-efficacy, hope, coping, and resilience, as well as gathering information about the demographic characteristics of nurse respondents. Out of a total potential sample of 1,730 OR nurses, the overall response rate was 51.7% (n = 896). Differences between the ACORN and hospital samples were found in age, years of experience, education and years of employment; therefore, the national and hospital samples’ findings were analysed separately. Five independent variables – hope, self-efficacy, coping, managing stress and competence – predicted resilience in the larger sample of ACORN respondents (n = 772). For the substantially smaller sample of hospital respondents (n = 124), hope, self-efficacy and managing stress predicted resilience. Given that the smaller hospital sample resulted in a similar model, this consistency lends strength and weight to the revised resilience model. Over 60% of the variance in resilience was explained by the independent variables in each model. Given the dearth of literature describing the efficacy of resilience in ameliorating stress in OR contexts, the results of this study have extended the theoretical application of the resilience concept to include a nursing context. There is a need to implement resilience-building strategies that address the culture of the OR, both at the departmental and organisational levels. Strategies that provide a supportive workplace environment in relation to goal-orientation, the provision of stress management and education programs, and strategies that facilitate cultural assimilation may improve resilience, and hence retention and recruitment rates in the OR. The findings of this study support the need for further research not only to test the stability of the proposed model among other groups of nurses but also to explore further predictors of resilience in the OR setting.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Full Text
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Taylor, Leah Kristine. "Objective measures of operating room wire navigation performance". Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/5656.
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There is no widely accepted tool to assess an orthopedic surgeon’s technical skill in the operating room. With changes in surgical education, simulators are being investigated for learning and assessing technical skills, but a link between the actual operating room is needed to ensure they are effective. Hip fracture surgery is a good starting point to develop these measures because hip fractures are common and fixation is a difficult task.
Resident orthopedic surgeons wore a head-mounted video camera during hip fracture surgery. Data collected included: duration, number of x-ray images, the supervising surgeon intervention, and tip-apex distance (TAD, a measure of how accurate the implant is placed). To determine the reliability of these measurements, four raters performed them for two cases. Ten raters measured the tip-apex distance (TAD) on 7 cases. These performance metrics for 15 cases were compared to experience of the residents, both point in residency and number of previous cases. A composite performance score was computed using the four metrics. The metrics were also compared to two practicing surgeons’ assessment of skill.
The inter-rater reliability of the performance metrics was high (0.97-0.99) showing these measures are consistent between different raters and useful for assessment. There was a significant relationship between resident experience and the metrics of duration and TAD. Expert opinion was related to duration.
These metrics provide objective assessment of resident technical performance in the operating room by a non-expert, an important step towards competency based education. Their validity is shown with correlation to surgical experience.
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Ogunjulugbe, Jacqueline P. "Decreasing Operating Room Delays for Surgical Orthopedic Patients". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6078.
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The operating room (OR) at the project site was experiencing surgical delays for orthopedic surgical patients due to unavailable instruments, which led to a decrease in the efficiency of OR utilization. The purpose of this project was to decrease operating room delays for the orthopedic surgical patients. The practice-focused question explored whether a multidisciplinary approach to the procurement of instruments and supplies for the orthopedic surgical patient would help to ensure an on-time surgery start, resulting in increased efficiency in the utilization of the OR from 42% to 65% within a 9-month period. Lewin's change model was used to guide the project. Data analysis was conducted using a t test to compare the changes in the mean scores of the OR utilization rate before and after the involvement of a multidisciplinary team. An independent samples t test found no significant effect of the intervention, t (13) = 0.74, p > .05. Because the t test results were not significant at the α = .05 level, results showed no evidence that the multidisciplinary team affected the OR utilization rate. Decreasing surgical delays can have the potential implication for positive social change at the organization level, because delays hinder optimal patient flow, increase anxiety for patient and families, and have a significant negative economic impact on hospitals.
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Woldehawariat, Negat. "Experiences of operating room nurses in their work environment at a state hospital in Ethiopia". Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1008177.
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Operating room nursing skills are some of the most demanding skills in the nursing profession. At the moment nurses trained in operating room technique are in very short supply in Ethiopia, due to the exodus of nurses to better working environments with more reasonable payment. This is especially noticeable in one of the state hospitals in Addis Ababa, Ethiopia, as emerged in conversations with the head nurse of the operating room in this hospital about the high turnover rate, as well as the high absenteeism rate amongst the nurses working in the operating room. Nurses working in the operating room also expressed unhappiness in their work environment which could cause them to look for other jobs or to be absent from duty. The nurses were facing numerous problems in their work environment such as work overload due to staff shortage, stress due to shortage of supplies because they are not able to do their job as much as the need requires. The researcher identified the need to explore the challenges that the operating room nurses are experiencing in their work environment. The researcher used the following questions to meet the research objectives: What are the experiences of the operating room nurses in their work environment?; What potential assistance would such nurses need to better cope with the problems they experience in their work environment? The research study aimed to explore and describe the experience of operating room nurses in their work environment and on the basis of the findings to develop guidelines to assist the operating room nurses in coping more effectively with their work environment. The researcher used a qualitative approach with an explorative, descriptive and contextual design. Fifteen registered nurses were selected using purposive sampling. Informed consent was obtained from the participants and permission from the Ethics Committee of the Nelson Mandela Metropolitan University, as well as Yekatit 12 Hospital. Data were gathered using face to face interviews and field notes were taken to determine the experiences of the participants. Data were analyzed using Tesch's method of descriptive data analysis (in Creswell, 2003:13). Two main themes with two sub-themes related to the experience of the registered nurses working in the operating room of the state hospital were identified. Main theme one focused on the non-conducive work environment and it focused on the lack of support from management and the problems experienced in the environment. It was found that OR nurses had good working relationships among the nursing staff. Main theme two focused on the limited training opportunities in OR techniques. The sub-themes described the limited exposure to new technology and the quality of nursing education which the participants felt was not taken seriously in Ethiopia. Based on the identified themes guidelines were formulated to assist the registered nurses working in the operating room of a state hospital in Ethiopia. Utilization of these guidelines should assist the registered nurses to cope more effectively with their work environment. Recommendation were made, further research and limitations identified.
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Van, Heerden Christelle. "Support for operating room personnel after a sharps injury / Christelle van Heerden". Thesis, North-West University, 2007. http://hdl.handle.net/10394/1897.
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Prince, Jacqueline Yvonne. "Operating room nursing science learning programmes in South Africa". Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/594.
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Operating room nurses form the corner-stone of the operating room because perioperative care of the patient rests mainly in the hands of the nursing personnel. Unique challenges face nurses functioning in the stressful surgical environment where anticipation to prevent or cope with life-threatening situations is the order of the day. The operating room nurse must be knowledgeable, skilled and alert, as he/she is held accountable for all acts of commission and omission. To ensure that nurses are appropriately educated and trained and able to keep trend with the changing technology in the operating room, it is essential that learning programmes meet the minimum standards for registration as prescribed by the South African Nursing Council. Reviewing and evaluating learning programmes on a regular basis by specialist nursing educationists, are therefore essential to ensure that the standards of education and training are maintained and upgraded if required. The aim of this study is to explore and describe the various Operating Room Nursing Science Learning Programmes offered at accredited Higher Education Institutions, utilized for the education and training of the operating room nursing students in South Africa. The proposed research is based on a qualitative paradigm and the theoretical grounding is found in Bergman’s model for professional accountability (Bergman, 1982:8). A document analysis of five approved comprehensive Operating Room Nursing Science Learning Programmes from higher education institutions in South Africa (nursing colleges and universities) was carried out, together with a sixth programme, the Operating Theatre Learning Programme, as suggested by the Standard Generating Body. Requests for permission were forwarded to the management of the selected colleges or universities for inclusion of the respective programmes in the study. The researcher formulated and utilized thirty-four essential criteria derived from three documents, the first being a document entitled “Proposed Standards for Nursing and Midwifery Qualifications” submitted to the SANC and SAQA by the SGB for Nursing and Midwifery (2001-2004). The second document entitled the Public and Private Higher Education Institutions format template for criteria for the Generation and Evaluation of Qualifications and Standards within the National Qualifications Framework was also utilized (SAQA, 1430/00) and thirdly the researcher included the most relevant criteria from the list of criteria for curriculum development as indicated by the South African Nursing Council. Various tables were compiled, to reflect the findings of the document analysis according to the thirty-three criteria indicated above, to provide a clear and broad overview of the specific data in the respective six Operating Room Nursing Science Learning Programmes utilized in the study. In conclusion recommendations for a broad macro-curriculum were made to facilitate formulation of programmes in Operating Room Nursing Science relevant to the South African context.
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Loy, Rodas Nicolas. "Context-aware radiation protection for the hybrid operating room". Thesis, Strasbourg, 2018. http://www.theses.fr/2018STRAD001/document.
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L’utilisation de systèmes d’imagerie à rayons X lors de chirurgies mini-invasives expose patients et staff médical à des radiations ionisantes. Même si les doses absorbées peuvent être faibles, l’exposition chronique peut causer des effets nocifs (e.g. cancer). Dans cette thèse, nous proposons des nouvelles méthodes pour améliorer la sécurité vis-à-vis des radiations ionisantes en salle opératoire hybride dans deux directions complémentaires. Premièrement, nous présentons des approches pour rendre les cliniciens plus conscients des irradiations grâce à des visualisations par réalité augmentée. Deuxièmement, nous proposons une méthode d'optimisation pour suggérer une pose de l’imageur réduisant la dose au personnel et patient, tout en conservant la qualité de l’image. Pour rendre ces applications possibles, des nouvelles approches pour la perception de la salle grâce à des caméras RGBD et pour la simulation en temps-réel de la propagation et doses de radiation ont aussi été proposéesThe use of X-ray imaging technologies during minimally-invasive procedures exposes both patients and medical staff to ionizing radiation. Even if the dose absorbed during a single procedure can be low, long-term exposure can lead to noxious effects (e.g. cancer). In this thesis, we therefore propose methods to improve the overall radiation safety in the hybrid operating room by acting in two complementary directions. First, we propose approaches to make clinicians more aware of exposure by providing in-situ visual feedback of the ongoing radiation dose by means of augmented reality. Second, we propose to act on the X-ray device positioning with an optimization approach for recommending an angulation reducing the dose deposited to both patient and staff, while maintaining the clinical quality of the outcome image. Both applications rely on approaches proposed to perceive the room using RGBD cameras and to simulate in real-time the propagation of radiation and the deposited dose
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Levesque, Marie-Julie. "Interprofessional Collaboration in the Operating Room: A Nursing Perspective". Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42751.
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The aim of this thesis was to examine the contribution of nurses to interprofessional collaboration (IPC) in the operating room (OR) guided by the Interprofessional Education Collaborative Patient Care Practice (IECPCP) framework. First, a secondary analysis of interviews with 19 registered nurses was conducted. Twenty emergent themes were identified. The most prevalent of the four dimensions (internalization; shared goals and vision; governance; and formalization) consisted of the internalization dimension relating to human interaction and sense of belonging within the interprofessional team. A scoping review then identified 20 studies evaluating four interventions (briefings, checklists, team training, and debriefings) used to improve IPC in the OR. Despite weak study designs, these interventions showed improvements in communication, teamwork, and safety outcomes. OR nurses contribute mainly through interactional processes and they require organizational support to foster their efforts in IPC. Nurse are involved in all IPC interventions and their contribution is important to support IPC in the OR.
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Yoo, Seung-jin. "Micromachined wavelength selective microbolometer sensors operating at room temperature /". Full text (PDF) from UMI/Dissertation Abstracts International, 2000. http://wwwlib.umi.com/cr/utexas/fullcit?p3004406.
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Rutherford, John. "Development of a behavioural rating system for the non-technical skills used by anaesthetic nurses and operating department practitioners". Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=225952.
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Unintentional harm due to healthcare is common, especially in the operating theatre. Previous research, aiming to reduce harm to patients in the operating theatre, has not examined the non-technical skills of anaesthetic assistants. The aim of this project was to identify the essential non-technical skills required by anaesthetic assistants for safe and effective practice, and to develop a behavioural marking system to assess these skills. A literature review identified three articles which described anaesthetic assistants' non-technical skills. An interview study with anaesthetic assistants (n=22) and anaesthetists (n=23) described the use of situation awareness, teamwork and task management more commonly than leadership or decision making. This was corroborated by a critical incident database review of the Australian Incident Monitoring System from 2002 to 2008. The material identified in the interview study was considered by focus groups of anaesthetic assistants (n=6,7,3,4) to generate headings. These themes were considered by anaesthetic assistant lecturers (n=6) in a Delphi questionnaire, and positive and negative behavioural markers proposed. The Anaesthetic Non-Technical Skills for Anaesthetic Practitioners (ANTS-AP) behavioural marker system was completed by a research panel. The prototype ANTS-AP system had three categories: 'situation awareness', 'communication and teamwork', and 'task management', each with three elements. The reliability, validity and usability of the ANTS-AP system were evaluated by anaesthetic assistants (n=48) observing videos of simulated theatre work at a 3.5 hour workshop. The system had good internal consistency, and was able to discriminate good, average and poor behaviours. The element 'coping with pressure' was removed due to its poor inter-rater reliability. Future work will assess the inter-rater reliability of the ANTS-AP system, when observers have the opportunity for calibration. This project has provided anaesthetic assistants a means of structuring observation and feedback for training and reflection with the goal of improving patient care.
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DÍAZ, CÉSAR DAVID LÓPEZ. "OPERATING ROOM SCHEDULING TO ELECTIVE PATIENTS, AN INTEGER PROGRAMMING MODEL". PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2015. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=25684@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIROCOORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO
As despesas anuais em saúde para a maioria dos países são crescentes. Segundo a Organização Mundial de Saúde (OMS), em 2011 o Brasil gastou aproximadamente 10 porcento do produto interno bruto em saúde. Consequentemente, incrementar a eficiência na prestação de serviços médicos está se tornando cada vez mais importante. Em um hospital as salas de cirurgia representam um dos principais centros de custos e de rendimentos. As salas de cirurgia são um aspecto difícil de gerenciar devido à prioridade das partes envolvidas no processo, nomeadamente, pacientes, cirurgiões, staff, pessoal administrativo, e a escassez de recursos como leitos, salas de cirurgia, equipamentos especiais, etc. A presente dissertação aborda um problema real de programação de salas de cirurgia para pacientes eletivos de um hospital em Lisboa, onde é proposta uma reformulação do modelo de PLI proposto por Marques et al. (2012). Esta reformulação é baseada no problema da mochila, com o objetivo de encontrar soluções mais eficientes em termos computacionais. De acordo com os testes realizados, uma modificação no modelo que quebre sua simetria além de fornecer uma solução mais eficiente computacionalmente, melhora a solução original pois diminui o gap inicial de 782,59 porcento para 2,25 porcento. Também foi proposto um modelo de simulação no que foram criados vários cenários para avaliar a incerteza envolvida, nos quais a duração média das cirurgias foi submetida a valores majorados. Esta simulação pode servir como ferramenta de apoio na tomada de decisões, pois de acordo com o grau de conservadorismo de quem toma as decisões, podem ser estabelecidas políticas de programação das Salas de Cirurgia.
For most countries annual health expenditures are increasing. According to the World Health Organization (WHO), in 2011, Brazil expends about 10 percent of its gross domestic product on health. Hence, improving health care efficiency is becoming increasingly important. Within a hospital, the Operating Rooms represent a major cost and incomes center. Operating Rooms are a difficult aspect to manage because many stakeholders involved in the process, namely, patients, surgeons, staff, hospital manager, and the scarcity of resources like beds, operating rooms, especial equipment, etc. This dissertation deals with a real problem of operating rooms programming for elective patients in a Lisbon hospital. For this problem, we propose a reformulation of the integer programming model proposed by Marques et al. (2012). This reformulation is based on the knapsack problem, in order to find a more efficient solution in terms of time. According to tests carried out, a reformulation in the model that breaks symmetry, computationally provides a more efficient solution and enhance the original solution because it reduces the initial gap from 782.59 percent to 2.25 percent. In addition, a simulation model was proposed to create various scenarios to assess the involved uncertainty, mainly due to surgery duration variation. This simulation can serve as a support tool in decision-making, according to the degree of conservatism of the decision maker, Operating Rooms scheduling policies can be established.
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Sadrizadeh, Sasan. "Design of Hospital Operating Room Ventilation using Computational Fluid Dynamics". Doctoral thesis, KTH, Strömnings- och klimatteknik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-181053.
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The history of surgery is nearly as old as the human race. Control of wound infection has always been an essential part of any surgical procedure, and is still an important challenge in hospital operating rooms today. For patients undergoing surgery there is always a risk that they will develop some kind of postoperative complication. It is widely accepted that airborne bacteria reaching a surgical site are mainly staphylococci released from the skin flora of the surgical staff in the operating room and that even a small fraction of those particles can initiate a severe infection at the surgical site. Wound infections not only impose a tremendous burden on healthcare resources but also pose a major threat to the patient. Hospital-acquired infection ranks amongst the leading causes of death within the surgical patient population. A broad knowledge and understanding of sources and transport mechanisms of infectious particles may provide valuable possibilities to control and minimize postoperative infections. This thesis contributes to finding solutions, through analysis of such mechanisms for a range of ventilation designs together with investigation of other factors that can influence spread of infection in hospitals, particularly in operating rooms. The aim of this work is to apply the techniques of computational fluid dynamics in order to provide better understanding of air distribution strategies that may contribute to infection control in operating room and ward environments of hospitals, so that levels of bacteria-carrying particles in the air can be reduced while thermal comfort and air quality are improved. A range of airflow ventilation principles including fully mixed, laminar and hybrid strategies were studied. Airflow, particle and tracer gas simulations were performed to examine contaminant removal and air change effectiveness. A number of further influential parameters on the performance of airflow ventilation systems in operating rooms were examined and relevant measures for improvement were identified. It was found that airflow patterns within operating room environments ranged from laminar to transitional to turbulent flows. Regardless of ventilation system used, a combination of all airflow regimes under transient conditions could exist within the operating room area. This showed that applying a general model to map airflow field and contaminant distribution may result in substantial error and should be avoided. It was also shown that the amount of bacteria generated in an operating room could be minimized by reducing the number of personnel present. Infection-prone surgeries should be performed with as few personnel as possible. The initial source strength (amount of colony forming units that a person emits per unit time) of staff members can also be substantially reduced, by using clothing systems with high protective capacity. Results indicated that horizontal laminar airflow could be a good alternative to the frequently used vertical system. The horizontal airflow system is less sensitive to thermal plumes, easy to install and maintain, relatively cost-efficient and does not require modification of existing lighting systems. Above all, horizontal laminar airflow ventilation does not hinder surgeons who need to bend over the surgical site to get a good view of the operative field. The addition of a mobile ultra-clean exponential laminar airflow screen was also investigated as a complement to the main ventilation system in the operating room. It was concluded that this system could reduce the count of airborne particles carrying microorganisms if proper work practices were maintained by the surgical staff. A close collaboration and mutual understanding between ventilation experts and surgical staff would be a key factor in reducing infection rates. In addition, effective and frequent evaluation of bacteria levels for both new and existing ventilation systems would also be important.Tidigt i mänsklighetens utveckling har kirurgin funnits med i bilden. Hantering av infektioner har genom tiderna varit en oundviklig del av alla kirurgiska ingrepp, och finns kvar ännu idag som en viktig utmaning i operationssalar på sjukhus. För patienter som genomgår kirurgi finns alltid en risk att de efter ingreppet utvecklar någon behandlingsrelaterad komplikation. Allmänt accepterat är att de luftburna bakterier som når operationsområdet huvudsakligen består av stafylokocker frigjorda från hudfloran av operationspersonalen i operationssalen, och att endast en liten del av dessa partiklar behövs för att initiera en allvarlig infektion i det behandlade området. Sårinfektioner innebär inte bara en enorm börda för hälso- och sjukvårdsresurser, utan utgör också en betydande risk för patienten. På sjukhus förvärvad infektion finns bland de främsta dödsorsakerna i kirurgiska patientgrupper.. En bred kunskap och förståelse av spridningsmekanismer och källor till infektionsspridande partiklar kan ge värdefulla möjligheter att kontrollera och minimera postoperativa infektioner. Denna avhandling bidrar till lösningar genom analys av en rad olika ventilationssystem tillsammans med undersökning av andra faktörer som kan påverka infektionsspridningen på sjukhus, främst i operationssalar. Syftet med arbetet är att med hjälp av CFD-teknik (Computational Fluid Dynamics) få bättre förståelse för olika luftspridningsmekanismers betydelse vid ventilation av operationssalar och vårdinrättningar på sjukhus, så att halten av bacteriebärande partiklar i luften kan minskas samtidigt som termisk komfort och luftkvalité förbättras. Flera luftflödesprinciper för ventilation inklusive omblandade strömning, riktad (laminär) strömning och hybridstrategier har studerats. Simuleringar av luft-, partikel- och spårgasflöden gjordes för alla fallstudier för att undersöka partikelevakuering och luftomsättning i rummet. Flera viktiga parametrar som påverkar detta undersöktes och relevanta förbättringar föreslås i samarbete med industrin. Av resultaten framgår att mängden genererade bakterier i en operationssal kan begränsas genom att minska antalet personer i operationsteamet. Infektionsbenägna operationer skall utföras med så lite personal som möjligt. Den initiala källstyrkan (mängden kolonibildande enheter som en person avger per tidsenhet) från operationsteamet kan avsevärt minskas om högskyddande kläder används. Av resultaten framgår också att ett horisontellt (laminärt) luftflöde kan vara ett bra alternativ till det ofta använda vertikala luftflödet. Ett horisontellt luftflöde är mindre känsligt för termisk påverkan från omgivningen, enkelt att installera och underhålla, relativt kostnadseffektivt och kräver vanligen ingen förändring av befintlig belysningsarmatur. Framför allt begränsar inte denna ventilationsprincip kirurgernas rörelsemönster. De kan luta kroppen över operationsområdet utan att hindra luftflödet. En flyttbar flexibel skärm för horisontell spridning av ultraren ventilationsluft i tillägg till ordinarie ventilation undersöktes också. Man fann att denna typ av tilläggsventilation kan minska antalet luftburna partiklar som bär mikroorganismer om operationspersonalen följer en strikt arbetsordning. Bra samarbete och förståelse mellan ventilationsexperter och operationsteamet på sjukhuset är nyckeln till att få ner infektionsfrekvensen. Det är också viktigt med effektiva och frekventa utvarderingar av bakteriehalten i luften, för såväl nya som befintliga ventilationssystem.
QC 20160129
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Slater, Michelle McHugh. "National Inquiry of Clinical Nurse Leadership in the Operating Room". Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1476639876263273.
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Vasoya, Miteshkumar Mahendrabhai. "Improve Operating Room Utilization through Distributed Scheduling Workflow and Automation". Wright State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=wright155917866666766.
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Gutekunst, Kevin Roy. "A REDESIGN OF THE ANESTHESIOLOGIST WORKPLACE IN THE OPERATING ROOM". Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/275283.
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Abedini, Amin. "TRADE-OFF BALANCING FOR STABLE AND SUSTAINABLE OPERATING ROOM SCHEDULING". UKnowledge, 2019. https://uknowledge.uky.edu/me_etds/141.
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The implementation of the mandatory alternative payment model (APM) guarantees savings for Medicare regardless of participant hospitals ability for reducing spending that shifts the cost minimization burden from insurers onto the hospital administrators. Surgical interventions account for more than 30% and 40% of hospitals total cost and total revenue, respectively, with a cost structure consisting of nearly 56% direct cost, thus, large cost reduction is possible through efficient operation management. However, optimizing operating rooms (ORs) schedules is extraordinarily challenging due to the complexities involved in the process. We present new algorithms and managerial guidelines to address the problem of OR planning and scheduling with disturbances in demand and case times, and inconsistencies among the performance measures. We also present an extension of these algorithms that addresses production scheduling for sustainability. We demonstrate the effectiveness and efficiency of these algorithms via simulation and statistical analyses.
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Alexander, Sherly Bejoy. "An Effective Succession Planning Educational Program for Operating Room Nurses". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2950.
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The current nationwide shortage of registered nurses is a growing problem impacting patient care and hospital operations. The operating room is the area most affected by the nursing shortage. Reasons cited for this shortage include ineffective nursing orientation programs and a decline in job satisfaction. The purpose of this project was to develop a best practice succession planning educational program to provide novice operating room nurses with an introduction to the operating room. The Dreyfus model of skills acquisition and Benner's novice to expert theory guided this project. A 2-step process was used to assess and validate the content and quality of the educational program. In Phase 1, the educational program was distributed to 10 operating room nurse stakeholders for formative review. There was agreement from these reviewers that the educational program covered key concepts important for novice operating room nurses. Two recommendations were made for additional clarification. In Phase II, the educational program was revised and distributed to a group of 10 perioperative professionals for summative review using the AGREE II instrument. The summative review group found the educational program to be clear and concise. The overall summative approval of 100% and recommendations of both review groups guided the final development of the best practice educational module. This best practice educational module will provide a standardized program for educating novice operating room nurses. This project will contribute to positive social change by empowering these nurses while supporting safe care for all surgical patients. Dissemination will occur first within the organization and then to local and national organizations targeting operating room nurses.
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Gunna, Vivek Reddy. "ADAPTIVE MULTI-OBJECTIVE OPERATING ROOM PLANNING WITH STOCHASTIC DEMAND AND CASE TIMES". UKnowledge, 2017. https://uknowledge.uky.edu/me_etds/108.
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The operating room (OR) is accountable for most hospital admissions and is one of the most cost and work intensive areas in the hospital. From recent trends, we discover an unexpected parallel increase in expenditure and waiting time. Therefore, improving OR planning has become obligatory, particularly regarding utilization, and service level. Significant challenges in OR planning are the high variations in demand, processing times of surgical specialties, the trade-off between the objectives, and control of OR performance in long-term. Our model provides OR configurations at a strategical level of OR planning to minimize the tradeoff between the utilization and service level accounting for variation in both demand and processing times of surgical specialties. An adaptive control scheme is proposed to aid OR managers to maintain the OR performance within the prescribed controllable limits. Our model is validated using a simulation of demand and processing time data of surgical services at University of Kentucky Health Care.
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Man, Mei-fun. "A survey of the incidence and causal factors related to occupational back pain in operating theatre nurses in a general acute hospital in Hong Kong /". View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31384663.
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Theron, Margot Cecile. "Nursing care practice related to patient safety in the operating room". Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1017197.
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Patient safety is a primary concern of members of the surgical team. Professional nurses working in the operating room play a vital role in the safety of the patients from the moment the patient enters the operating room to the discharge of the patient to the unit. Quality nursing care is of the utmost importance and therefore it is the responsibility of a professional nurse to ensure patient safety during the peri-operative period. Team work and good communication in the operating room are essential in order to ensure patient safety. Nursing care practices related to patient safety should be a key aspect to consider in rendering care to the surgical patient and professional nurses should perform their duties to the best of their ability despite lack of resources and shortage of staff. The main purpose of the study was to explore and describe nursing care practice related to patient safety in the operating room at hospitals in the Nelson Mandela Metropolitan area. Once this was established recommendations on how to enhance nursing care practice related to patient safety in the operating room were made. This study is based on a quantitative, explorative, descriptive and contextual design. Convenient sampling was used in this study. Data were collected by means of a self-administered questionnaire. Descriptive and inferential statistics were used to analyse the data. Ethical considerations were adhered to and the findings of the research will be disseminated appropriately. Recommendations based on the findings that emerge from the data, as well as the literature review, will be offered to enhance nursing care practice related to patient safety in the operating room.
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Sham, Gregory C. (Gregory Chi-Keung). "Developing a data-driven approach for improving operating room scheduling processes". Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/73397.
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Thesis (M.B.A.)--Massachusetts Institute of Technology, Sloan School of Management; and, (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division; in conjunction with the Leaders for Global Operations Program at MIT, 2012.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 52).
In the current healthcare environment, the cost of delivering patient care is an important concern for hospitals. As a result, healthcare organizations are being driven to maximize their existing resources, both in terms of infrastructure and human capital. Using a data-driven approach with analytical techniques from operations management can contribute towards this goal. More specifically, this thesis shows, drawing from a recent project at Beth Israel Deaconess Medical Center (BIDMC), that predictive modeling can be applied to operating room (OR) scheduling in order to effectively increase capacity. By examining the current usage of the existing block schedule system at BIDMC and developing a linear regression model, OR time that is expected to go unused can be instead identified in advance and freed for use. Sample model results show that it is expected to be operationally effective by capturing a large enough portion of OR time for a pooled set of blocks to be useful for advanced scheduling purposes. This analytically determined free time represents an improvement in how the current block system is employed, especially in terms of the nominal block release time. This thesis makes the argument that such a model can integrate into a scheduling system with more efficient and flexible processes, ultimately resulting in more effective usage of existing resources.
by Gregory C. Sham.
S.M.
M.B.A.
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Meyer, Rhoda. "Students perceptions of the operating room as a clinical learning environment". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/95860.
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Thesis (MPhil)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room, for example, is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite the numerous studies that have been undertaken in this field, few studies that have investigated the operating room as a clinical learning environment in the South African healthcare system have been published. The aim of this study was to determine students’ perceptions of the operating room as a clinical learning environment in a private hospital context. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Data was collected from nursing students undertaking their training at a private nursing education institution. Ten nursing students participated in an open-ended questionnaire (N=10), and twelve students participated in the focus group discussion (N=12). From the results, four themes emerged, namely, ‘interpersonal factors’, ‘educational factors’, ‘private operating room context’, and ‘recommendations’. This study has highlighted some of the challenges experienced by students in the private sector operating room context. Despite the potential learning opportunities, the key findings reveal negative perceptions of students regarding learning experiences. However, the opinion that the operating room offers an opportunity to gain skills unique to this context, as well as facilitates the integration of theory and practice, was also expressed. Some students reported that the emphasis on profitability and cost to patient, and the lack of a mentoring process in this context posed a constraint to learning. Exploration into the specific preparatory needs of students specific to learning outcomes before operating room placement should be considered. It would also be necessary to improve collaboration between lecturers, mentors and theatre managers so that a structured teaching programme may be developed for students entering the perioperative environment.
AFRIKAANSE OPSOMMING: Studente onderneem hul kliniese plasing in verskeie kliniese omgewings vir die blootstelling aan en aanleer van vaardighede wat verband hou met daardie spesifieke konteks. Die operasiesaal, byvoorbeeld, is ’n kliniese omgewing wat die geleentheid bied om kritiese vaardighede te ontwikkel wat verband hou met die perioperatiewe versorging van die pasiënt. Ten spyte van die talle studies wat in die operasiesaal onderneem was, het slegs ’n paar studies uit ’n Suid-Afrikaanse gesondheidsorg oogpunt, die operasiesaal as ’n kliniese opleidings omgewing ondersoek. Die doel van hierdie studie was om studente se persepsies van die operasiesaal as ’n kliniese omgewing in ’n privaat hospitaal konteks te bepaal. ’n Ondersoekende, verklarende en beskrywende ontwerp wat kwalitatiewe data genereer, is gebruik. Data is ingesamel van verpleegstudente wat hul opleiding by ’n privaat verpleegonderrig instelling ontvang. Tien verpleegstudente (N=10) was genooi om ’n onbepaalde vraelys te voltooi en twaalf student (N=12) het aan die fokusgroep bespreking deelgeneem. Vier temas het na vore gekom, naamlik ‘interpersoonlike faktore’, ‘opvoedkundige faktore’, ‘privaat-operasiesaal konteks’, en ‘aanbevelings’. Hierdie studie het ’n paar van die uitdagings uitgelig wat die studente in ’n privaat sektor operasiesaal ondervind. Ten spyte van die potensiële leergeleenthede teenwoordig in die privaat sektor operasiesaal, toon die belangrikste bevindings egter die negatiewe persepsies van studente jeens hierdie kliniese omgewing. Die opinie is egter ook uitgespreek dat hierdie omgewing ook ’n geleentheid aanbied om unieke vaardighede aan te leer. Dit bied ook ’n geleentheid om teorie en praktiese kundigheid te integreer. Sommige studente rapporteer dat die klem op winsgewendheid en koste vir die pasiënt, asoók die gebrek aan mentorskap in hierdie kliniese omgewing ’n beperking plaas op die leerproses. Die spesifieke voorbereidings behoeftes van studente insake leeruitkomste voordat plasing in die operasiesaal omgewing geskied, moet eers deeglik ondersoek word. Dit is ook nodig om die nodige samewerking tussen dosente, mentors en operasiesaal bestuurders te verbeter sodat ’n gestruktureerde onderrig program ontwikkel kan word vir studente wat die perioperatiewe omgewing betree.
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Tanaka, Masayuki. "Development of efficiency indicators of operating room management for multi-institutional comparisons". 京都大学 (Kyoto University), 2013. http://hdl.handle.net/2433/175184.
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Hajdukiewicz, John R. "Development of a structured approach for patient monitoring in the operating room". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0013/MQ34145.pdf.
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Brinkman, Mary Adams. "A focused ethnography| Experiences of registered nurses transitioning to the operating room". Thesis, Widener University School of Nursing, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3570586.
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The operating room (OR) is a unique setting and specialty area of nursing practice that requires optimal orientation and education to render safe and efficient patient care. Unfortunately, there will be a significant shortage of nurses in the operating room in the next five to ten years. The need for new nurses in the operating room is essential as many OR nurses in the workforce will retire within the next five years. Currently, most nursing programs no longer offer perioperative courses in their curriculum. Subsequently, this trend has led to the need for hospitals to educate and orient new nurses to their operating rooms. As hospitals educate their own OR nurses, retention following orientation becomes a priority.
The purpose of this study was to explore nurses' experiences as they transition to a new area of nursing practice, the operating room. A qualitative focused ethnography was conducted using Leininger's ethnonursing research method. Fourteen RNs transitioning to the OR agreed to participate in this study. The OR was a first time experience for the RNs. The setting was a large teaching hospital located in an urban area. Observations and interviews were conducted with the RNs to explore their experiences as they transitioned in the OR.
The RNs' transition included learning the didactics of OR nursing through the web-based AORN Nursing 101 online computer course, practicing skills learned in a simulation laboratory, and rotating through surgical specialty areas under the supervision of an RN preceptor. Influences that facilitated the RNs transition to the OR were the
positive learning experience, perception of belonging and acceptance into the OR culture, stimulating environment, supportive personnel, collegiality among peers, and presence of nursing in the OR. Influences that hindered the RNs' transition to the OR were inconsistency in precepting, being in a hostile environment, limited exposure to the OR prior to the RNs' transition, and an overwhelming environment. Meleis' Transition model emerged in the RNs' experiences of transitioning to the OR.
The need to educate nurses in the operating room is essential to assure safety and positive outcomes for the surgical patient. Structured perioperative courses implemented by hospitals or with partnerships with nursing programs can enhance the education, transition, and retention of nurses new to the OR. The importance of a nurse educator having an advanced degree with experience in the OR specialty was essential in coordinating and mentoring nurses transitioning to this new practice area. RNs who are prepared to precept were vital in the education and retention of these RNs. The need for consistent preceptors was recognized as an essential factor to the RNs' successful transition. The findings contribute to evidence-base practice for the design and implementation of perioperative programs for new nurses.
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Jay, Rita A. "Relationship of organizational work climate to nurse turnover in operating room settings". Thesis, Capella University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3724927.
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Organizational work climates in healthcare organizations were described in the literature using a social framework of structured interactions, defined roles, and behavioral responses between team members of physicians and nurses. It was hypothesized that the characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy in socially complex work settings have relationships to turnover intent in nurses who work in operating room settings. In an era of nursing shortages the challenge of nurse retention and the evidence of challenging work climate become even more critical for healthcare organizations. This research study examined a gap in knowledge regarding the extent to which aspects of organizational work climate predict nurse turnover in operating room work settings. A quantitative correlational study using three work climate characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy was conducted using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (Hojat & Herman, 1985, Developing an Instrument to Measure Attitudes toward Nurses: Preliminary Psychometric Findings) and the Anticipated Turnover Scale (Hinshaw & Atwood, 1983, Nursing Staff Turnover, Stress, and Satisfaction: Models, Measures, and Management). Responses from 322 Operating Room staff nurses who were members of a national professional nursing organization were examined in the analyses. The study concluded that the independent variables of collaboration, dominance, and autonomy were not significant in predicting turnover among nurses in the operating room setting.
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Escat, Alexandre. "Conception and development of a preliminary analysis of the operating room performance". Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-228016.
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Operating room performance is becoming more and more important for the hospital’s finance and the patient’s well-being. Thus, hospitals need to develop dashboards that can assess the actual performance of its core service, to be able to decide how to improve it. The point of this thesis is to build a common audit tool which can be used in regular hospitals. To build so, a literature review has been made, gathering all the relevant organizational and performance indicators. Since only a few of them need to be selected, a group of experts has been gathered via the Delphi method to decide which indicators to keep and which ones to reject, for the implementation in the tool. Out of forty-two indicators found in the literature, only fifteen will be considered and implemented into graphs. These graphs will form the preliminary audit from which hospital and consultants can base their performance assessment of the operating room, by pinpointing what their analysis should focus on. This tool has been tested in a real hospital to identify a few improvements that the tool requires and the few technical mistakes the tool possessed. The tool can save time for the consultants and for the hospital. Saving time in the healthcare sector ultimately means having more time for the patients, which, in the end, enhances their experience and well-being. It allows some flexibility as well and can be adapted even more to the needs of the studied hospitals. Moreover, compared to simple dashboards, this tool will give more useful indicators and help hospital’s management to take some decisions and reconsider others - again, for the best outcome for the patientsOperationssalens prestation blir mer och mer viktig för sjukhusets ekonomi och patienternas välmående. Därför behöver sjukhusen utveckla instrumentbrädor som kan utvärdera hur denna huvudtjänst presterar, för att sedan kunna bestämma hur man bäst förbättrar den. För att skapa ett sådant hjälpmedel har en litteraturöversikt gjorts för att samla alla relevanta indikatorer från organisationen och dess prestationer. Eftersom endast en bråkdel av dessa behövs så har en grupp med experter sållats ut genom Delphi-metoden; denna bestämde vilka indikatorer som borde behållas respektive avslås, för implementering i hjälpmedlet. Av fyrtiotvå indikatorer kommer endast femton att övervägas och implementeras i grafer. Dessa grafer kommer att skapa den preliminära revision från vilken sjukhus och konsulter kan basera sin prestationsutvärdering av operationssalarna; hjälpmedlet sätter fingret på vad analysen bör fokusera på. Detta hjälpmedel har prövats i ett riktigt sjukhus för att identifiera ett fåtal nödvändiga förbättringar, samt de få tekniska problem som hjälpmedlet hade. Detta hjälpmedel kan spara tid för sjukhus och konsulter. Visserligen skulle man kunna skapa en egen instrumentbräda, noga anpassad till det studerade sjukhuset, men då lär hjälpmedlet inte kunna användas i andra kontexter; man kan också använda ett mer komplext men detaljerat hjälpmedel, men detta kräver mer tid för att förstå hur den bör användas. I sjukvården innebär sparad tid att mer tid kan läggas på patienterna, vilket i slutändan förbättrar deras upplevelser och välmående. Dessutom kommer detta hjälpmedel, i jämförelse med enkla instrumentbrädor, att bidra med mer användbara indikatorer och hjälpa sjukhusets ledning att ta somliga beslut och omvärdera andra – än en gång för patienternas bästa.
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Navabi-Shirazi, Mohammad Jafar. "Integration of operating room monitors for development of a smart alarm system". Diss., The University of Arizona, 1990. http://hdl.handle.net/10150/185184.
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A computer based system was designed and used to collect physiologic and respiratory data (13 variables and 3 waveforms) from six routinely used operating room monitors. 23 hours of data were collected during 20 general surgery cases (ASA III patients). Part of the data were used to design and implement an integrated monitor with intelligent alarm capability. The system used a rule based approach to reduce false alarms and artificial neural networks (ANN) for classification of physiological waveforms. The integrated monitor was able to correctly identify 13 of 17 intubations which resulted in a 42% reduction in low end-tidal-CO₂ false alarms. False heart rate alarms were reduced to 2.6% of total alarms using multi-variable analysis and rate of change limits. A combination of ANN's and an edge detection filter was used to classify CO₂ waveforms into spontaneous, mechanical, and mechanical with spontaneous breathing attempts. The edge detection algorithm was able to detect 171 of 182 breaths. The ANN's properly classified 65 of 67 mechanical, 47 of 71 spontaneous, and 37 of 44 mechanical breaths with spontaneous breathing attempts. Another ANN was used for detection of elevated and depressed ST segments in the ECG signal. All ST segment elevations and depressions of 0.1 mV were correctly identified. An attempt was made to use ANN's to classify ECG waveforms according to anesthetic levels. However, the back-propagation algorithm used to train the network did not converge perhaps due to the variety of drugs used in the different cases. The system met our goals of providing an integrated operating room monitor with intelligent alarm capability. The system significantly reduced false heart rate alarms, detected intubation and classified ECG and CO₂ waveforms.
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Cosgrove, Marianne S. "PERCEIVED IMPACT OF AMBIENT OPERATING ROOM NOISE BY CERTIFIED REGISTERED NURSE ANESTHETISTS". VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5963.
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It is widely acknowledged that elevated levels of noise are commonplace in the healthcare environment, particularly in high acuity areas such as the operating room (OR). Excessive ambient noise may pose a threat to patient safety by adversely impacting provider performance and interfering with communication among perioperative care team members. With respect to the certified registered nurse anesthetist (CRNA), increased ambient OR noise may engender distractibility, diminish situation awareness and cause untoward health effects, thereby increasing the possibility for the occurrence of error and patient injury.
This research project analytically examines the perceived impact of ambient noise in the operating room by CRNAs. Findings from this study reveal that CRNAs perceive elevated noise to be regularly present in the OR, specifically during the critical emergence phase of the anesthetic. However, CRNAs feel that increased noise only occasionally limits their ability to perform procedures, concentrate and communicate with the perioperative team. OR noise rarely interferes with memory retrieval. CRNAs perceive that noise is sometimes a threat to patient safety but infrequently engenders adverse patient outcomes. CRNAs do not perceive noise in the OR to be detrimental to their health but strongly agree that excessive noise can and should be controlled.
Increased ambient OR noise is a veritable reality that may pose a potential threat to patient safety. Further research to identify elevations in noise during critical phases of the anesthetic and delineation of significant contributors to its genesis is warranted.
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Boson, Maria, i Linda Smedman. "Operationssjuksköterskans upplevelse av sin yrkesroll : -en kvalitativ intervjustudie". Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-13527.
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Bakgrund Yrket som operationssjuksköterska är idag den äldsta sjuksköterskespecialiteten men förblir främst en dold yrkesroll på grund av att det utövas bakom stängda dörrar. Yrkesrollen skildrades som komplex och kretsade omkring patienten, samarbetet och den tekniska utrustningen Patricia Benners teorier om sjuksköterskans yrkesutveckling användes som teoretisk förankring i studien. Syfte Studiens syfte var att belysa hur operationssjuksköterskan upplever sin yrkesroll. Metod Studien genomfördes med en kvalitativ ansats och tio semistrukturerade intervjuer utfördes med operationssjuksköterskor från två sjukhus i Sverige under våren 2011. Alla intervjuer spelades in och transkriberades ordagrant. Insamlat data analyserades med kvalitativ innehållsanalys. Resultat I textanalysen identifierades tolv subkategorier och fyra kategorier; rollen som omvårdnadsansvarig, upplevelsen av vad som gör operationssjuksköterskan trygg i sin yrkesroll, betydelsen av att vara medarbetare i arbetet på operationssalen och synen på den egna professionen. Operationssjuksköterskorna beskrev sitt arbete som patientfokuserat och möjligheten att hjälpa medförde känslan av att göra skillnad. Erfarenhet och uppskattning gav ett självförtroende som resulterade i att operationssjuksköterskorna blev trygga i sin yrkesroll. Operationssjuksköterskorna beskrev kommunikation på salen som essentiellt för ett fungerande samarbete och menade att de anpassade sig efter sina medarbetare. Operationssjuksköterskorna upplevde sin yrkesroll både som osynlig och utvecklande. Citat från informanterna presenterades i texten för att tydliggöra resultatet. Slutsats Studien visade att operationssjuksköterskorna har en central roll för omvårdnaden på operationsavdelningen och för patienten. Operationssjuksköterskans närvaro och kompetens vid operationer var oersättlig men ständigt beroende av teamet omkring sig.Background The profession of operating room nurse is now the oldest nursing specialty, but remains primarily a hidden profession because it is exercised behind closed doors. The professional role were described as complex and revolved around the patient, cooperation and the technical equipment. Patricia Benners theories on the nurses’ professional development were used as a theoretical basis in the study. Aim The study aimed to elucidate how the operating room nurse perceives the professional role. Method The study was conducted with a qualitative approach and ten semi-structured interviews were carried out with operating room nurses from two hospitals in Sweden in spring 2011. All interviews were recorded and transcribed verbatim. To analyze the collected data content analysis with an inductive approach was used. Result In the text analysis twelve subcategories and four categories were identified: the role as being responsible of nursing, the experience of what makes the operating room nurse safe in the professional role, the meaning of being a co-worker during the work on the operating room and the view on the own profession Quotes from the informants were presented in the text to clarify the result. Conclusion The study showed that the operating room nurse has a central role for nursing in the surgical ward and the patient. The operating room nurse presence and expertise in operations was irreplaceable, but always dependent of the team around him/her.
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Richardson-Tench, Marilyn 1947. "Unmasked! : the discursive practice of the operating room nurse : a Foucauldian feminist analysis". Monash University, Faculty of Education, 2001. http://arrow.monash.edu.au/hdl/1959.1/8900.
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Zheng, Liying. "Operating Room Version of Safety Attitudes Questionnaire – An Analysis Using Structural Equation Models". Thesis, Uppsala universitet, Statistiska institutionen, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-175920.
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Siegel, Hugh Andrew. "Subjectivity Of Estimating Blood Loss Among Health Care Providers In The Operating Room". VCU Scholars Compass, 1993. https://scholarscompass.vcu.edu/etd/5263.
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This research utilized a descriptive study to establish a relationship between educational background and accuracy of estimating blood loss. The null hypothesis, that the educational background of health care providers in the operating room has no effect on the accuracy of estimating blood loss , was tested. Ten nurse anesthesia students, 8 certified registered nurse anesthetists, 16 operating room registered nurses, 12 anesthesiologists, and 9 surgeons were included in the sample population. A number of different protocols were utilized to assess the relative accuracy of blood volumes estimates. The study was separated into four stations. Station 1 consisted of three tables, each with different sizes and types of sponges with varying amounts of blood placed on them. Four estimates were required at each table, for a total of 12 estimates. Stations 2-3-4 contained different aggregates of blood-soaked materials, requiring a single estimate at each station. Repeated measures analysis of variance (ANOVA) revealed that the means across all groups in Station 1 reached statistical significance beyond p = .05 (< .001), and the hypothesis is rejected for equal group means. However, the results for Stations 2-3-4 for equal group means did not reach statistical significance ( p = .136), therefore, do not reject the null hypothesis of equal group means.
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Котенко, М. М. "Оцінка ефективності роботи операційного залу ВАТ "Ощадбанк" за допомогою СМО типу M|M|N|". Thesis, Видавництво СумДУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/4289.
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Hilton, George Leslie. "SENSORY REGRESSION TIME FROM SUBARACHNOID BLOCK WITH HYPERBARIC 0.75% BUPIVACAINE IN THE OBESE PATIENT". VCU Scholars Compass, 1989. http://scholarscompass.vcu.edu/etd/5067.
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The purpose of this study was to determine if obese patients have a different sensory regression time from subarachnoid block than non-obese patients using hyperbaric 0.75% bupivacaine. A quasi-experimental design was used. Twenty patients were separated into two groups; one group was classified as obese, and the other group was classified as non-obese. The data consisting of age, height, weight, sex, and surgical procedure were recorded preoperatively. All the patients received hyperbaric 0.75% bupivacaine via subarachnoid puncture. The levels of spinal anesthesia were recorded at the highest level achieved. The injection time was also recorded. When the surgery was completed, the patient was transferred to the recovery room and levels of sensory blockade were checked by pin-prick with an 18-gauge needle every 10 minutes until complete recovery from the spinal anesthesia had been achieved.
The hypothesis, there will be no difference in sensory regression time from SAB with hyperbaric 0.75% bupivacaine between obese and non-obese patients, failed to be rejected. No statistically significant difference, using linear regression analysis, was found in mean regression time between groups (obese versus non-obese).
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Hudalla, Christa Choate. "The Effect of Tourniquet Application On Systemic Coagulation". VCU Scholars Compass, 1992. http://scholarscompass.vcu.edu/etd/5073.
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Seven orthopedic surgery patients requiring the use of a tourniquet were studied. The hypothesis stated that tourniquet application does not affect coagulation. A total of 5 blood samples were drawn perioperatively (preoperative, 5 minutes after induction of anesthesia, 30 minutes after tourniquet inflation, 2 - 5 minutes after tourniquet deflation, and 30 minutes after tourniquet deflation. For each sample, TEG parameters (R, R + k, MA and α) were measured.
The value for each TEG parameter was compared by analysis of variance (ANOVA), then the samples were contrasted and examined by repeated measures ANOVA. None of the TEG parameters showed a statistically significant difference in the blood samples before, during or after tourniquet application. The hypothesis could not be rejected at the α = .05 level of significance. A t test was used to examine the effect of anesthesia on coagulation. The TEG parameters indicated a significant relationship between the TEG values R and R + k, and a near significant relationship between TEG values MA and a and the administration of anesthesia.
It was concluded that tourniquet use does not effect coagulation when applied 2 hours or less. However, anesthesia had a significant effect on TEG parameters R and R + k. The clinical significance of this effect was questionable since the type of anesthesia varied in some patients, and none of the patients in the study demonstrated symptoms of coagulopathy.
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Osborne, Sonya Ranee, i n/a. "Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia". University of Canberra. Nursing, 2002. http://erl.canberra.edu.au./public/adt-AUC20060823.161225.
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Occupational exposures of healthcare workers tend to occur because of
inconsistent compliance with standard precautions. Also, incidence of occupational
exposure is underreported among operating room personnel. The purpose of this
project was to develop national estimates for compliance with standard precautions
and occupational exposure reporting practices among operating room nurses in
Australia. Data was obtained utilizing a 96-item self-report survey. The Standard
Precautions and Occupational Exposure Reporting survey was distributed
anonymously to 500 members of the Australian College of Operating Room Nurses.
The Health Belief Model was the theoretical framework used to guide the analysis of
data. Data was analysed to examine relationships between specific constructs of the
Health Belief Model to identify factors that might influence the operating room nurse
to undertake particular health behaviours to comply with standard precautions and
occupational exposure reporting. Results of the study revealed compliance rates of
55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with
using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0%
with adequate eye protection. Although 31.6% of respondents indicated receiving an
occupational exposure in the past 12 months, only 82.6% of them reported their
exposures. The results of this study provide national estimates of compliance with
standard precautions and occupational exposure reporting among operating room
nurses in Australia. These estimates can now be used as support for the development
and implementation of measures to improve practices in order to reduce occupational
exposures and, ultimately, disease transmission rates among this high-risk group.
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Kavanaugh, Irenaanna. "A Phenomenological Study of How Leadership Efficacy Affects the Culture of Operating Room Safety". Thesis, Northcentral University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10634329.
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Patient safety remains a global challenge that has required constant resolve to improve personnel skills, responsiveness to detail, and transformational actions. This phenomenological study explored how an operating room?s culture of patient safety was affected by the efficacy of its leadership in managing its critical qualitative safety characteristics. Despite the current technological advances and various patient safety measures, studies have reported not only an increasing number of preventable sentinel events, but also recurring mistakes that continue to cause death or serious health complications. There have been numerous administrative attempts to improve the culture of safety in the operating room using performance evaluations, check off sheets, patient satisfaction surveys, and educational seminars. However, the number of patient safety infractions continues to increase. There has not been a model that investigated how leadership efficacy affected an operating room?s culture of patient safety. The paradigm applied in this study established the relevance that leadership efficacy could have in strengthening the operating room?s culture of safety. The hermeneutic-styled, phenomenological case study examined the operating room personnel?s perception of the operating room?s leadership efficacy, and how the personnel?s perceptions of the quality safety characteristics affected the culture of patient safety. The study implemented a non-probability, non-random sample that consisted of 18 skilled surgical personnel of a Level II Trauma Center facility located in Central Florida. The study employed a phenomenological methodology of collection and hermeneutic dissection of interview data. Analysis revealed several findings that established a positive link between each of the qualitative safety characteristics, the qualities of effective leadership, and a progressive culture of patient safety. Future studies could be expanded to include operating room personnel from multiple facilities of the same health organization, and operating room personnel from multiple facilities of multiple health organizations.