Limiting factors for wearing personal protective equipment (PPE) in a health care environment evaluated in a randomised study.

Pandemics and re-emerging diseases put pressure on the health care system to prepare for patient care and sample logistics requiring enhanced personnel protective equipment (PPE) for health care workers. We generated quantifiable data on ergonomics of PPE applicable in a health care setting by defining error rates and physically limiting factors due to PPE-induced restrictions. Nineteen study volunteers tested randomly allocated head- or full body-ventilated PPE suits equipped with powered-air-purifying-respirators and performed four different tasks (two laboratory tutorials, a timed test of selective attention and a test investigating reaction time, mobility, speed and physical exercise) during 6 working hours at 22°C on one day and 4 working hours at 28°C on another day. Error rates and physical parameters (fluid loss, body temperature, heart rate) were determined and ergonomic-related parameters were assessed hourly using assessment sheets. Depending on the PPE system the most restrictive factors, which however had no negative impact on performance (speed and error rate), were: reduced dexterity due to multiple glove layers, impaired visibility by flexible face shields and back pain related to the respirator of the fully ventilated suit. Heat stress and liquid loss were perceived as restrictive at a working temperature of 28°C but not 22°C

A.49 Design and Development of a Mobile Computer Application to Reengineer Workflows in the Hospital and the Methodology to Evaluate its Effectiveness

AbstractThis paper describes a new method of collecting additional data for the purpose of skin cancer research from the patients in the hospital using the system Mobile Computing in Medicine Graz (MoCoMed-Graz). This system departs from the traditional paper-based questionnaire data collection methods and implements a new composition of evaluation methods to demonstrate its effectiveness.The patients fill out a questionnaire on a Tablet-PC (or iPad Device) and the resulting medical data is integrated into the electronic patient record for display when the patient enters the doctor’s examination room. Since the data is now part of the electronic patient record, the doctor can discuss the data together with the patient making corrections or completions where necessary, thus enhancing data quality and patient empowerment. A further advantage is that all questionnaires are in the system at the end of the day – and manual entry is no longer necessary – consequently raising data completeness. The front end was developed using a User Centered Design Process for touch tablet computers and transfers the data in XML to the SAP based enterprise hospital information system. The system was evaluated at the Graz University Hospital – where about 30 outpatients consult the pigmented lesion clinic each day – following Bronfenbrenner’s three level perspective: The microlevel, the mesolevel and the macrolevel:On the microlevel, the questions answered by 194 outpatients, evaluated with the System Usability Scale (SUS) resulted in a median of 97.5 (min: 50, max: 100) which showed that it is easy to use.On the mesolevel, the time spent by medical doctors was measured before and after the implementation of the system; the medical task performance time of 20 doctors (age median 43 (min: 29; max: 50)) showed a reduction of 90%.On the macrolevel, a cost model was developed to show how much money can be saved by the hospital management. This showed that, for an average of 30 patients per day, on a 250day basis per year in this single clinic, the hospital management can save up to 40,000 EUR per annum, proving that mobile computers can successfully contribute to workflow optimization

The Impact of Visual Guided Order Picking on Ocular Comfort, Ocular Surface and Tear Function

<div><p>Purpose</p><p>We investigated the effects of a visual picking system on ocular comfort, the ocular surface and tear function compared to those of a voice guided picking solution.</p><p>Design</p><p>Prospective, observational, cohort study.</p><p>Method</p><p><i>Setting</i>: Institutional. <i>Study Population</i>: A total of 25 young asymptomatic volunteers performed commissioning over 10 hours on two consecutive days. <i>Main Outcome Measures</i>: The operators were guided in the picking process by two different picking solutions, either visually or by voice while their subjective symptoms and ocular surface and tear function parameters were recorded.</p><p>Results</p><p>The visual analogue scale (VAS) values, according to subjective dry eye symptoms, in the visual condition were significantly higher at the end of the commissioning than the baseline measurements. In the voice condition, the VAS values remained stable during the commissioning. The tear break-up time (BUT) values declined significantly in the visual condition (pre-task: 16.6 sec and post-task: 9.6 sec) in the right eyes, that were exposed to the displays, the left eyes in the visual condition showed only a minor decline, whereas the BUT values in the voice condition remained constant (right eyes) or even increased (left eyes) over the time. No significant differences in the tear meniscus height values before and after the commissioning were observed in either condition.</p><p>Conclusion</p><p>In our study, the use of visually guided picking solutions was correlated with post-task subjective symptoms and tear film instability.</p></div

Subjective Values.

<p>Subjective Values.</p

Voice guided system.

<p>Voice guided system.</p

Objective values.

<p>Objective values.</p