Search results for: hospital waste management (HWM)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12862

Search results for: hospital waste management (HWM)

12052 Physical, Chemical and Mineralogical Characterization of Construction and Demolition Waste Produced in Greece

Authors: C. Alexandridou, G. N. Angelopoulos, F. A. Coutelieris

Abstract:

Construction industry in Greece consumes annually more than 25 million tons of natural aggregates originating mainly from quarries. At the same time, more than 2 million tons of construction and demolition waste are deposited every year, usually without control, therefore increasing the environmental impact of this sector. A potential alternative for saving natural resources and minimize landfilling, could be the recycling and re-use of Concrete and Demolition Waste (CDW) in concrete production. Moreover, in order to conform to the European legislation, Greece is obliged to recycle non-hazardous construction and demolition waste to a minimum of 70% by 2020. In this paper characterization of recycled materials - commercially and laboratory produced, coarse and fine, Recycled Concrete Aggregates (RCA) - has been performed. Namely, X-Ray Fluorescence and X-ray diffraction (XRD) analysis were used for chemical and mineralogical analysis respectively. Physical properties such as particle density, water absorption, sand equivalent and resistance to fragmentation were also determined. This study, first time made in Greece, aims at outlining the differences between RCA and natural aggregates and evaluating their possible influence in concrete performance. Results indicate that RCA’s chemical composition is enriched in Si, Al, and alkali oxides compared to natural aggregates. X-ray diffraction (XRD) analyses results indicated the presence of calcite, quartz and minor peaks of mica and feldspars. From all the evaluated physical properties of coarse RCA, only water absorption and resistance to fragmentation seem to have a direct influence on the properties of concrete. Low Sand Equivalent and significantly high water absorption values indicate that fine fractions of RCA cannot be used for concrete production unless further processed. Chemical properties of RCA in terms of water soluble ions are similar to those of natural aggregates. Four different concrete mixtures were produced and examined, replacing natural coarse aggregates with RCA by a ratio of 0%, 25%, 50% and 75% respectively. Results indicate that concrete mixtures containing recycled concrete aggregates have a minor deterioration of their properties (3-9% lower compression strength at 28 days) compared to conventional concrete containing the same cement quantity.

Keywords: chemical and physical characterization, compressive strength, mineralogical analysis, recycled concrete aggregates, waste management

Procedia PDF Downloads 221
12051 Waste Egg Albumin Derived Small Peptides Stimulate Photosynthetic Electron Transport

Authors: Seungwon Han, Sung young Yoo, Tae Wan Kim

Abstract:

The objective of this study was to measure the changes in the photochemical response in the leaves of red pepper (Capsium annuum L.) after foliar fertilization of amino acid and small peptides derived from the waste egg. As a nitrogen fertilizer, waste eggs were incubated over one 1week and then degraded as amino acids and small peptides. The smaller peptides less than 20 kDa were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS). MALDI-TOF-MS as a rapid analysis method was to show the molecular mass of degraded egg protein. The sequences of peptides were identified as follows; γ-Glu- Cys-γ-Glu-Cys-γ-Glu-Cys)-Ser and γ-Glu-Cys-γ-Glu-Cys-γ-Glu- Cys)-Gly. It was clearly illuminated that the parameters related to quantum yields for PSI electron transport (ΦRE1O, ΨRE1O, δRE1O) and RC/ABS have increased tendency by small peptide application. On the other hand, phenomenological energy fluxes (ABSO/CSM, TRO/CSM, ET2O/CSM, RE1O/CSM, DIO/CSM) have considerably fluctuated with foliar fertilization of small peptides. In conclusion, the small peptides can enhance the photochemical activities from photosystem II to photosystem I. This study was financially supported by RDA Agenda Project PJ 016196012022.

Keywords: electron transport, foliar fertilization, small peptide, waste egg

Procedia PDF Downloads 148
12050 A Novel Alginate/Tea Waste Complex for Restoration and Conservation of Historical Textiles Using Immobilized Enzymes

Authors: Mohamed E. Hassan

Abstract:

Through numerous chemical linkages, historical textiles in burial contexts or in museums are exposed to many different forms of stains and filth. The cleaning procedure must be carried out carefully without causing any irreparable harm, and sediments must be removed without damaging the surface's original material. Science and technology continue to develop novel methods for cleaning historical textiles and artistic surfaces biologically (using enzymes). Lipase and α-amylase were immobilized on nanoparticles of alginate/tea waste nanoparticle complex and used in historical textile cleaning. The preparation of nanoparticles, activation, and enzyme immobilization were characterized. Optimization of loading times and units of the two enzymes was done. It was found that the optimum time and units of amylase were 3 hours and 30 U, respectively. While the optimum time and units of lipase were 2.5 hours and 20 U, respectively, FT-IR and TGA instruments were used in proving the preparation of nanoparticles and the immobilization process. SEM was used to examine the fibres before and after treatment. In conclusion, a new carrier was prepared from alginate/Tea waste and optimized to be used in the restoration and conservation of historical textiles using immobilized lipase and α-amylase.

Keywords: alginate/tea waste, nanoparticles, immobilized enzymes, historical textiles

Procedia PDF Downloads 72
12049 A Global Perspective on Urban Environmental Problems in Developing Countries: The Case of Turkey

Authors: Nükhet Konuk, N. Gamze Turan, Yüksel Ardalı

Abstract:

Cities play a vital role in the social fabric of countries and in national and regional economic growth worldwide; however, the environmental effects of such growth need to be assessed and managed better. The critical and most immediate problems faced by cities of developing countries are the health impacts of urban pollution that derive from inadequate water, sanitation, drainage and solid waste services, poor urban and industrial waste management, and air pollution. As globalization continues, earth's natural processes transform local problems into international issues. The aim of this study is to provide a broad overview of the pollution from urban wastes and emissions in Turkey which is a developing country. It is aimed to underline the significance of reorganizing the institutional tools in a worldwide perspective in order to generate coherent solutions to urban problems, and to enhance urban quality.

Keywords: environmental pollution, developing countries, environmental degradation, urban environmental problems

Procedia PDF Downloads 311
12048 The Reasons for Food Losses and Waste and the Trends of Their Management in Basic Vegetal Production in Poland

Authors: Krystian Szczepanski, Sylwia Łaba

Abstract:

Production of fruit and vegetables, food cereals or oilseeds affects the natural environment via intake of nutrients being contained in the soil, use of the resources of water, fertilizers and food protection products, and energy. The limitation of the mentioned effects requires the introduction of techniques and methods for cultivation being friendly to the environment and counteracting losses and waste of agricultural raw materials as well as the appropriate management of food waste in every stage of the agri-food supply chain. The link to basic production includes obtaining a vegetal raw material and its storage in agricultural farm and transport to a collecting point. When the plants are ready to be harvested is the initial point; the stage before harvesting is not considered in the system of measuring and monitoring the food losses. The moment at which the raw material enters the stage of processing, i.e., its receipt at the gate of the processing plant, is considered as a final point of basic production. According to the Regulation (EC) No 178/2002 of the European Parliament and of the Council of 28 January 2002, Art. 2, “food” means any substance or product, intended to be, or reasonably expected to be consumed by humans. For the needs of the studies and their analysis, it was determined when raw material is considered as food – the plants (fruit, vegetables, cereals, oilseeds), after being harvested, arrive at storehouses. The aim of the studies was to determine the reasons for loss generation and to analyze the directions of their management in basic vegetal production in Poland in the years 2017 and 2018. The studies on food losses and waste in basic vegetal production were carried out in three sectors – fruit and vegetables, cereals and oilseeds. The studies of the basic production were conducted during the period of March-May 2019 at the territory of the whole country on a representative trail of 250 farms in each sector. The surveys were carried out using the questionnaires by the PAP method; the pollsters conducted the direct questionnaire interviews. From the conducted studies, it is followed that in 19% of the examined farms, any losses were not recorded during preparation, loading, and transport of the raw material to the manufacturing plant. In the farms, where the losses were indicated, the main reason in production of fruit and vegetables was rotting and it constituted more than 20% of the reported reasons, while in the case of cereals and oilseeds’ production, the respondents identified damages, moisture and pests as the most frequent reason. The losses and waste, generated in vegetal production as well as in processing and trade of fruit and vegetables, or cereal products should be appropriately managed or recovered. The respondents indicated composting (more than 60%) as the main direction of waste management in all categories. Animal feed and landfill sites were the other indicated directions of management. Prevention and minimization of loss generation are important in every stage of production as well as in basic production. When possessing the knowledge on the reasons for loss generation, we may introduce the preventive measures, mainly connected with the appropriate conditions and methods of the storage. Production of fruit and vegetables, food cereals or oilseeds affects the natural environment via intake of nutrients being contained in the soil, use of the resources of water, fertilizers and food protection products, and energy. The limitation of the mentioned effects requires the introduction of techniques and methods for cultivation being friendly to the environment and counteracting losses and waste of agricultural raw materials as well as the appropriate management of food waste in every stage of the agri-food supply chain. The link to basic production includes obtaining a vegetal raw material and its storage in agricultural farm and transport to a collecting point. The starting point is when the plants are ready to be harvested; the stage before harvesting is not considered in the system of measuring and monitoring the food losses. The successive stage is the transport of the collected crops to the collecting point or its storage and transport. The moment, at which the raw material enters the stage of processing, i.e. its receipt at the gate of the processing plant, is considered as a final point of basic production. Processing is understood as the change of the raw material into food products. According to the Regulation (EC) No 178/2002 of the European Parliament and of the Council of 28 January 2002, Art. 2, “food” means any substance or product, intended to be, or reasonably expected to be consumed by humans. It was determined (for the needs of the present studies) when raw material is considered as a food; it is the moment when the plants (fruit, vegetables, cereals, oilseeds), after being harvested, arrive at storehouses. The aim of the studies was to determine the reasons for loss generation and to analyze the directions of their management in basic vegetal production in Poland in the years 2017 and 2018. The studies on food losses and waste in basic vegetal production were carried out in three sectors – fruit and vegetables, cereals and oilseeds. The studies of the basic production were conducted during the period of March-May 2019 at the territory of the whole country on a representative trail of 250 farms in each sector. The surveys were carried out using the questionnaires by the PAPI (Paper & Pen Personal Interview) method; the pollsters conducted the direct questionnaire interviews. From the conducted studies, it is followed that in 19% of the examined farms, any losses were not recorded during preparation, loading, and transport of the raw material to the manufacturing plant. In the farms, where the losses were indicated, the main reason in production of fruit and vegetables was rotting and it constituted more than 20% of the reported reasons, while in the case of cereals and oilseeds’ production, the respondents identified damages, moisture, and pests as the most frequent reason. The losses and waste, generated in vegetal production as well as in processing and trade of fruit and vegetables, or cereal products should be appropriately managed or recovered. The respondents indicated composting (more than 60%) as the main direction of waste management in all categories. Animal feed and landfill sites were the other indicated directions of management. Prevention and minimization of loss generation are important in every stage of production as well as in basic production. When possessing the knowledge on the reasons for loss generation, we may introduce the preventive measures, mainly connected with the appropriate conditions and methods of the storage. ACKNOWLEDGEMENT The article was prepared within the project: "Development of a waste food monitoring system and an effective program to rationalize losses and reduce food waste", acronym PROM implemented under the STRATEGIC SCIENTIFIC AND LEARNING PROGRAM - GOSPOSTRATEG financed by the National Center for Research and Development in accordance with the provisions of Gospostrateg1 / 385753/1/2018

Keywords: food losses, food waste, PAP method, vegetal production

Procedia PDF Downloads 98
12047 Audit Outcome Cardiac Arrest Cases (2019-2020) in Emergency Department RIPAS Hospital, Brunei Darussalam

Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

Abstract:

Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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12046 A Fuzzy Multiobjective Model for Bed Allocation Optimized by Artificial Bee Colony Algorithm

Authors: Jalal Abdulkareem Sultan, Abdulhakeem Luqman Hasan

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With the development of health care systems competition, hospitals face more and more pressures. Meanwhile, resource allocation has a vital effect on achieving competitive advantages in hospitals. Selecting the appropriate number of beds is one of the most important sections in hospital management. However, in real situation, bed allocation selection is a multiple objective problem about different items with vagueness and randomness of the data. It is very complex. Hence, research about bed allocation problem is relatively scarce under considering multiple departments, nursing hours, and stochastic information about arrival and service of patients. In this paper, we develop a fuzzy multiobjective bed allocation model for overcoming uncertainty and multiple departments. Fuzzy objectives and weights are simultaneously applied to help the managers to select the suitable beds about different departments. The proposed model is solved by using Artificial Bee Colony (ABC), which is a very effective algorithm. The paper describes an application of the model, dealing with a public hospital in Iraq. The results related that fuzzy multi-objective model was presented suitable framework for bed allocation and optimum use.

Keywords: bed allocation problem, fuzzy logic, artificial bee colony, multi-objective optimization

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12045 Detoxification and Recycling of the Harvested Microalgae using Eco-friendly Food Waste Recycling Technology with Salt-tolerant Mushroom Strains

Authors: J. M. Kim, Y. W. Jung, E. Lee, Y. K. Kwack, , S. K. Sim*

Abstract:

Cyanobacterial blooms in lakes, reservoirs, and rivers have been environmental and social issues due to its toxicity, odor, etc. Among the cyanotoxins, microcystins exist mostly within the cyanobacterial cells, and they are released from the cells. Therefore, an innovative technology is needed to detoxify the harvested microalgae for environment-friendly utilization of the harvested microalgae. This study develops detoxification method of microcystins in the harvested microalgae and recycling harvested microalgae with food waste using salt-tolerant mushroom strains and natural ecosystem decomposer. During this eco-friendly organic waste recycling process, diverse bacteria or various enzymes of the salt-tolerant mushroom strains decompose the microystins and cyclic peptides. Using PHLC/Mass analysis, it was verified that 99.8% of the microcystins of the harvested microalgae was detoxified in the harvested mushroom as well as in the recycled organic biomass. Further study is planned to verify the decomposition mechanisms of the microcystins by the bacteria or enzymes. In this study, the harvested microalgae is mixed with the food waste, and then the mixed toxic organic waste is used as mushroom compost by adjusting the water content of about 70% using cellulose such as sawdust cocopeats and cottonseeds. The mushroom compost is bottled, sterilized, and salt-tolerant mushroom spawn is inoculated. The mushroom is then cultured and growing in the temperature, humidity, and CO2 controlled environment. During the cultivation and growing process of the mushroom, microcystins are decomposed into non-toxic organic or inorganic compounds by diverse bacteria or various enzymes of the mushroom strains. Various enzymes of the mushroom strains decompose organics of the mixed organic waste and produce nutritious and antibiotic mushrooms. Cultured biomass compost after mushroom harvest can be used for organic fertilizer, functional bio-feed, and RE-100 biomass renewable energy source. In this eco-friendly organic waste recycling process, no toxic material, wastewater, nor sludge is generated; thus, sustainable with the circular economy.

Keywords: microalgae, microcystin, food waste, salt-tolerant mushroom strains, sustainability, circular economy

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12044 Co-Liquefaction of Cellulosic Biomass and Waste Plastics

Authors: Katsumi Hirano, Yusuke Kakuta, Koji Yoshida, Shozo Itagaki, Masahiko Kajioka, Toshihiko Okada

Abstract:

A conversion technology of cellulosic biomass and waste plastics to liquid fuel at low pressure and low temperature has been investigated. This study aims at the production of the liquefied fuel (CPLF) of substituting diesel oil by mixing cellulosic biomass and waste plastics in the presence of solvent. Co-liquefaction of cellulosic biomass (Japan cedar) and polypropylene (PP) using wood tar or mineral oil as solvent at 673K with an autoclave was carried out. It was confirmed that the co-liquefaction gave CPLF in a high yield among the cases of wood or of polypropylene Which was ascribed the acceleration of decomposition of plastics by radicals derived from the decomposition of wood. The co-liquefaction was also conducted by a small twin screw extruder. It was found that CPLF was obtained in the co-liquefaction, And the acceleration of decomposition of plastics in the presence of cellulosic biomass. The engine test of CPLF showed that the engine performances, Compression ignition and combustion characteristics were almost similar to those of diesel fuel at any mixing ratio of CPLF and any load, Therefore, CPLF could be practically used as alternative fuel for diesel engines.

Keywords: Cellulosic Biomass, Co-liquefaction, Solvent, Waste Plastics

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12043 The Inclusion of the Cabbage Waste in Buffalo Ration Made of Sugarcane Waste and Its Effect on Characteristics of the Silage

Authors: Adrizal, Irsan Ryanto, Sri Juwita, Adika Sugara, Tino Bapirco

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The objective of the research was to study the influence of the inclusion of the cabbage waste into a buffalo rations made of sugarcane waste on the feed formula and characteristic of complete feed silage. Research carried out a two-stage i.e. the feed formulation and experiment of making complete feed silage. Feed formulation is done by linear programming. Data input is the price of feed stuffs and their nutrient contents as well as requirements for rations, while the output is the use of each feed stuff and the price of complete feed. The experiment of complete feed silage was done by a completely random design 4 x 4. The treatments were 4 inclusion levels of the cabbage waste i.e. 0%,(T1) 5%(T2), 10%(T3) and 15% (T4), with 4 replications. The result of feed formulation for T1 was cabbage (0%), sugarcane top (17.9%), bagasse (33.3%), Molasses (5.0%), cabagge (0%), Thitonia sp (10.0%), rice brand (2.7%), palm kernel cake (20.0%), corn meal (9.1%), bond meal (1.5%) and salt (0.5%). The formula of T2 was cabagge (5%), sugarcane top (1.7%), bagasse (45.2%), Molasses (5.0%), , Thitonia sp (10.0%), rice brand (3.6%), palm kernel cake (20.0%), corn meal (7.5%), bond meal (1.5%) and salt (0.5%). The formula of T3 was cabbage (10%), sugarcane top (0%), bagasse (45.3%), Molasses (5.0%), Thitonia sp (10.0%), rice brand (3.8%), palm kernel cake (20.0%), corn meal (3.9%), bond meal (1.5%) and salt(0.5%). The formula of T4 was cabagge (15.0%), sugarcane top (0%), bagasse (44.1%), Molasses (5.0%), Thitonia sp (10.0%), rice brand (3.9%), palm kernel cake (20.0%), corn meal (0%), bond meal (1.5%) and salt (0.5%). An increase in the level of inclusion of the cabbage waste can decrease the cost of rations. The cost of rations (IDR/kg on DM basis) were 1442, 1367, 1333, and 1300 respectively. The rations formula were not significantly (P > 0.05) influent the on fungal colonies, smell, texture and color of the complete ration silage, but the pH increased significantly (P < 0.05). It concluded that inclusion of cabbage waste can minimize the cost of buffalo ration, without decreasing the silage quality of complete feed.

Keywords: buffalo, cabbage, complete feed, sillage characteristic, sugarcane waste

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12042 Job Satisfaction Levels of Nurses Working in Public Hospitals

Authors: S. Kurt, B. C. Demirbag

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Meeting employees’ expectations from an organization physically and mentally is a result of one’s assessing his or her work and its environment as well as his feeling about them. It was to determine the job satisfaction levels of the nurses in public hospitals. This descriptive study was carried out with 404 nurses (60%) accepting to take part in the study voluntarily and working in the same hospital for at least three months from 673 nurses working in hospitals depending on The Secretaryship of Public Hospital Association in Rize. The study aimed to reach the whole population by not taking samples. The data were collected by the personal information form (16 questions) prepared by the researcher, and the job satisfaction scale (36 articles) between June 1st and August 30th, 2014. According to scale, mean scores of nurses’ job satisfaction were 3.23±0.51. In addition, it was determined that the factors such as nurses’s age, marital status, childbearing, place of duty, position in workplace, being liked of job, education status, work experience, weekly working hours, maturing in professional practice, unit worked, hospital worked and colleagues affected the job satisfaction levels of nurses (p <0.05). In conclusion; the nurses’ general job satisfaction levels were moderate level.

Keywords: hospitals, job satisfaction level, nurses, public hospitals

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12041 Synthesis of Amorphous Nanosilica Anode Material from Philippine Waste Rice Hull for Lithium Battery Application

Authors: Emie A. Salamangkit-Mirasol, Rinlee Butch M. Cervera

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Rice hull or rice husk (RH) is an agricultural waste obtained from milling rice grains. Since RH has no commercial value and is difficult to use in agriculture, its volume is often reduced through open field burning which is an environmental hazard. In this study, amorphous nanosilica from Philippine waste RH was prepared via acid precipitation method. The synthesized samples were fully characterized for its microstructural properties. X-ray diffraction pattern reveals that the structure of the prepared sample is amorphous in nature while Fourier transform infrared spectrum showed the different vibration bands of the synthesized sample. Scanning electron microscopy (SEM) and particle size analysis (PSA) confirmed the presence of agglomerated silica particles. On the other hand, transmission electron microscopy (TEM) revealed an amorphous sample with grain sizes of about 5 to 20 nanometer range and has about 95 % purity according to EDS analyses. The elemental mapping also suggests that leaching of rice hull ash effectively removed the metallic impurity such as potassium element in the material. Hence, amorphous nanosilica was successfully prepared via a low-cost acid precipitation method from Philippine waste rice hull. In addition, initial electrode performance of the synthesized samples as an anode material in Lithium Battery have been investigated.

Keywords: agricultural waste, anode material, nanosilica, rice hull

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12040 The Cultural Significance of Recycling - A Native American Perspective

Authors: Martin A. Curry

Abstract:

Madeline Island is a small island community in Wisconsin, USA. Located in Lake Superior, it has been home to the Anishinaabe/Ojibway people for 1000s of years and is known as Moningwankuaning Minis-"The Island of the Golden Breasted Woodpecker". The community relies on summer tourism as its source of income, with a small population of 400 year-round residents. Supervisor Martin A. Curry (Ojibway/German descent) has been working on a fiscally responsible, environmentally principled and culturally centered approach to waste diversion and recycling. The tenets of this program encompass plastics, paper, food waste, local farming, energy production and art education. Through creative writing for the local newspaper and creative interactions, Martin has worked to engage the community in a more robust interest in waste diversion, including setting up a free-will donation store that incorporates elder volunteering opportunities, a compost program that works with the local community garden, biodiesel production and an art program that works with children from the local island school to make paper, grow local food and paint murals. The entirety of this program is based on the Ojibway concept of Mino-Bimadiiziwiin- "The Good Life" and benefits the community and its guests and represents a microcosm of the global dilemmas of waste and recycling.

Keywords: recycling, waste diversion, island, Native American, art

Procedia PDF Downloads 87
12039 Separation of Composites for Recycling: Measurement of Electrostatic Charge of Carbon and Glass Fiber Particles

Authors: J. Thirunavukkarasu, M. Poulet, T. Turner, S. Pickering

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Composite waste from manufacturing can consist of different fiber materials, including blends of different fiber. Commercially, the recycling of composite waste is currently limited to carbon fiber waste and recycling glass fiber waste is currently not economically viable due to the low cost of virgin glass fiber and the reduced mechanical properties of the recovered fibers. For this reason, the recycling of hybrid fiber materials, where carbon fiber is combined with a proportion of glass fiber, cannot be processed economically. Therefore, a separation method is required to remove the glass fiber materials during the recycling process. An electrostatic separation method is chosen for this work because of the significant difference between carbon and glass fiber electrical properties. In this study, an experimental rig has been developed to measure the electrostatic charge achievable as the materials are passed through a tube. A range of particle lengths (80-100 µm, 6 mm and 12 mm), surface state conditions (0%SA, 2%SA and 6%SA), and several tube wall materials have been studied. A polytetrafluoroethylene (PTFE) tube and recycled without sizing agent was identified as the most suitable parameters for the electrical separation method. It was also found that shorter fiber lengths helped to encourage particle flow and attain higher charge values. These findings can be used to develop a separation process to enable the cost-effective recycling of hybrid fiber composite waste.

Keywords: electrostatic charging, hybrid fiber composites, recycling, short fiber composites

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12038 Incidence and Causes of Elective Surgery Cancellations in Songklanagarind Hospital, Thailand

Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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12037 Review on the Role of Sustainability Techniques in Development of Green Building

Authors: Ubaid Ur Rahman, Waqar Younas, Sooraj Kumar Chhabira

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Environmentally sustainable building construction has experienced significant growth during the past 10 years at international level. This paper shows that the conceptual framework adopts sustainability techniques in construction to develop environment friendly building called green building. Waste occurs during the different construction phases which causes the environmental problems like, deposition of waste on ground surface creates major problems such as bad smell. It also gives birth to different health diseases and produces toxic waste agent which is specifically responsible for making soil infertile. Old recycled building material is used in the construction of new building. Sustainable construction is economical and saves energy sources. Sustainable construction is the major responsibility of designer and project manager. The designer has to fulfil the client demands while keeping the design environment friendly. Project manager has to deliver and execute sustainable construction according to sustainable design. Steel is the most appropriate sustainable construction material. It is more durable and easily recyclable. Steel occupies less area and has more tensile and compressive strength than concrete, making it a better option for sustainable construction as compared to other building materials. New technology like green roof has made the environment pleasant, and has reduced the construction cost. It minimizes economic, social and environmental issues. This paper presents an overview of research related to the material use of green building and by using this research recommendation are made which can be followed in the construction industry. In this paper, we go through detailed analysis on construction material. By making suitable adjustments to project management practices it is shown that a green building improves the cost efficiency of the project, makes it environmental friendly and also meets future generation demands.

Keywords: sustainable construction, green building, recycled waste material, environment

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12036 Design and Development of a Computerized Medical Record System for Hospitals in Remote Areas

Authors: Grace Omowunmi Soyebi

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A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved; this may cause an unexpected to happen to the patient. This data mining application is to be designed using a structured system analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the design and implementation of a computerized medical record system. This computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, data, software development, innovation

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12035 Evaluation of Medication Errors in Outpatient Pharmacies: Electronic Prescription System vs. Paper System

Authors: Mera Ababneh, Sayer Al-Azzam, Karem Alzoubi, Abeer Rababa'h

Abstract:

Background: Medication errors are among the most common medical errors. Their occurrences result in patient’s mortality, morbidity, and additional healthcare costs. Continuous monitoring and detection is required. Objectives: The aim of this study was to compare medication errors in outpatient’s prescriptions in two different hospitals (paper system vs. electronic system). Methods: This was a cross sectional observational study conducted in two major hospitals; King Abdullah University Hospital (KAUH) and Princess Bassma Teaching Hospital (PBTH) over three months period. Data collection was conducted by two trained pharmacists at each site. During the study period, medication prescriptions and dispensing procedures were screened for medication errors in both participating centers by two trained pharmacist. Results: In the electronic prescription hospital, 2500 prescriptions were screened in which 631 medication errors were detected. Prescription errors were 231 (36.6%), and dispensing errors were 400 (63.4%) of all errors. On the other side, analysis of 2500 prescriptions in paper-based hospital revealed 3714 medication errors, of which 288 (7.8%) were prescription errors, and 3426 (92.2%) were dispensing errors. A significant number of 2496 (67.2%) were inadequately and/or inappropriately labeled. Conclusion: This study provides insight for healthcare policy makers, professionals, and administrators to invest in advanced technology systems, education, and epidemiological surveillance programs to minimize medication errors.

Keywords: medication errors, prescription errors, dispensing errors, electronic prescription, handwritten prescription

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12034 Impact of Physiotherapy on COVID-19 and Post COVID-19 Patients, (Expert Physiotherapy and American Hospital, Case Study)

Authors: Jonida Hasanaj

Abstract:

Abstract: Four years after the pandemic, numerous studies discuss the long-term effects of COVID-19 on patients, with chronic fatigue syndrome being a prominent concern. Understanding the mechanisms behind this syndrome is crucial for developing prevention, treatment, and rehabilitation strategies. The appropriateness of physiotherapeutic treatment in covid 19 and post-COVID-19 patients has remained uncertain due to inconsistent diagnostic criteria, highlighting the need for further research. This paper intends to offer guidelines and specific suggestions for hospital-based physical therapists managing COVID-19 hospitalized patients at ‘’Expert Physiotherapy’ and ’American Hospital’ in Albania using a national approach in accordance with worldwide initiatives. Several studies indicate that chronic tiredness syndrome and high intracranial pressure could result from failure of the post-Covid-19 lymphatic system. Enabling the patient to intensify their physical activity and enhance their ability to move, exercise, and even resume a regular life cycle is the aim of physiotherapy treatment.

Keywords: mobility, physiotherapy, post-covid 19, rehabilitation, results

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12033 Biodiesel Production from Broiler Chicken Waste

Authors: John Abraham, Ramesh Saravana Kumar, Francis, Xavier, Deepak Mathew

Abstract:

Broiler slaughter waste has become a major source of pollution throughout the world. Utilization of broiler slaughter waste by dry rendering process produced Rendered Chicken Oil (RCO) a cheap raw material for biodiesel production and Carcass Meal a feed ingredient for pets and fishes. Conversion of RCO into biodiesel may open new vistas for generating wealth from waste besides controlling the major havoc of environmental pollution. A two-step process to convert RCO to good quality Biodiesel was invented. Acid catalysed esterification of FFA followed by base catalysed transesterification of triglycerides was carried out after meticulously standardising the methanol molar ratio, catalyst concentration, reaction temperature and reaction time to obtain the maximum biodiesel yield of 97.62% and lowest glycerol yield of 6.96%. RCO biodiesel blended was tested in a Mahindra Scorpio CRDI engine. The results revealed that the blending of commercial diesel with 20% RCO biodiesel lead to less engine wear, a quieter engine and better fuel economy. The better lubricating qualities of RCO B20 prevented over heating of engine, which prolongs the engine life. The blending of biodiesel at 20% to commercial diesel can reduce the import of costly crude oil and simultaneously, substantially reduce the engine emissions as proved by significantly lower smoke levels, thus mitigating climatic changes.

Keywords: broiler waste, rendered chicken oil, biodiesel, engine testing

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12032 Establishing a Communication Framework in Response to the COVID-19 Pandemic in a Tertiary Government Hospital in the Philippines

Authors: Nicole Marella G. Tan, Al Joseph R. Molina, Raisa Celine R. Rosete, Soraya Elisse E. Escandor, Blythe N. Ke, Veronica Marie E. Ramos, Apolinario Ericson B. Berberabe, Jose Jonas D. del Rosario, Regina Pascua-Berba, Eileen Liesl A. Cubillan, Winlove P. Mojica

Abstract:

Emergency risk and health communications play a vital role in any pandemic response. However, the Philippine General Hospital (PGH) lacked a system of information delivery that could effectively fulfill the hospital’s communication needs as a COVID-19 referral hospital. This study aimed to describe the establishment of a communication framework for information dissemination within a tertiary government hospital during the COVID-19 pandemic and evaluated the perceived usefulness of its outputs. This is a mixed quantitative-qualitative study with two phases. Phase 1 documented the formation and responsibilities of the Information Education Communication (IEC) Committee. Phase 2 evaluated its output and outcomes through a hospital-wide survey of 528 healthcare workers (HCWs) using a pre-tested questionnaire. In-depth explanations were obtained from five focused group discussions (FGD) amongst various HCW subgroups. Descriptive analysis was done using STATA 16 while qualitative data were synthesized thematically. Communication practices in PGH were loosely structured at the beginning of the pandemic until the establishment of the IEC Committee. The IEC Committee was well-represented by concerned stakeholders. Nine types of infographics tackled different aspects of the hospital’s health operations after thorough inputs from concerned offices. Internal and external feedback mechanisms ensured accurate infographics. Majority of the survey respondents (98.67%) perceived these as useful in their work or daily lives. FGD participants cited the relevance of infographics to their occupations, suggested improvements, and hoped that these efforts would be continued in the future. Sustainability and comprehensive reach were the main concerns in this undertaking. The PGH COVID-19 IEC framework was developed through trial and testing as there were no existing formal structures to communicate health risks and to properly direct the HCWs in the chaotic time of a pandemic. It is a continuously evolving framework which is perceived as useful by HCWs and is hoped to be sustained in the future.

Keywords: COVID-19, pandemic, health communication, infographics, social media

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12031 The Differences and Similarities between the Ship Waste Tracking Regulations of Turkey and Particular European Union Member Countries

Authors: Kaan Koyuncu, Umut Celen Arican, Sevilay Can

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In the maritime industry, there have been regulations to prevent pollution, and the first attempt to offer a legal basis was Marpol Convention which was held in 1973 in order to provide a framework for the disposal of ship wastes. Based on this convention, ports are obliged to build waste receiving facilities. European Union regulations make several member countries to follow these directions, In Turkey, under Blue Card System, the quantity and types of wastes, the delivery time, the capacity of the receiving facilities, and other required information can be monitored online. Therefore, yachts and other boats with the bilge, sewage, and waste which illegally discharge into the sea, can be blocked. This system is an outcome of the law adopted from European Union regulations. In this study, the present systems in Turkey which occurred in 2010 after the integration of the system, which has been put in the force in 2000 in Europe will be analyzed and interpreted to provide a useful comparison, a practical guide, and a roadmap for potential improvements.

Keywords: Europe-Turkey, blue card, marine environment, ship waste tracking system

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12030 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

Abstract:

Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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12029 Studies on Lucrative Design of a Waste Heat Recovery System for Air Conditioners

Authors: Ashwin Bala, K. Panthalaraja Kumaran, S. Prithviraj, R. Pradeep, J. Udhayakumar, S. Ajith

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In this paper, studies have been carried out for an in-house design of a waste heat recovery system for effectively utilizing the domestic air conditioner heat energy for producing hot water. Theoretical studies have been carried to optimizing the flow rate for getting maximum output with a minimum size of the heater. Critical diameter, wall thickness, and total length of the water pipeline have been estimated from the conventional heat transfer model. Several combinations of pipeline shapes viz., spiral, coil, zigzag wound through the radiator has been attempted and accordingly shape has been optimized using heat transfer analyses. The initial condition is declared based on the water flow rate and temperature. Through the parametric analytical studies we have conjectured that water flow rate, temperature difference between incoming water and radiator skin temperature, pipe material, radiator material, geometry of the water pipe viz., length, diameter, and wall thickness are having bearing on the lucrative design of a waste heat recovery system for air conditioners. Results generated through the numerical studies have been validated using an in-house waste heat recovery system for air conditioners.

Keywords: air conditioner design, energy conversion system, radiator design for energy recovery systems, waste heat recovery system

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12028 Sudan’s Approach to Knowledge Management in Disaster Management

Authors: Mohamed Abdalla Elamein Boshara, Peter Charles Woods, Nour Eldin Mohamed Elshaiekh

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Knowledge Management has become very important for Disaster Management response and planning. This paper proposes the implementation of a Knowledge Management System with a sustainable data collection mechanism for reliable and timely information management to support decision makers in making the right decisions in the timely manner.

Keywords: knowledge management, disaster management, incident tracking, web application

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12027 Analysis of the Recovery of Burnility Index and Reduction of CO2 for Cement Manufacturing Utilizing Waste Cementitious Powder as Alternative Raw Material of Limestone

Authors: Kwon Eunhee, Park Dongcheon, Jung Jaemin

Abstract:

In countries around the world, environmental regulations are being strengthened, and Korea is no exception to this trend, which means that environment pollution and the environmental load have recently become a significant issue. For this reason, in this study limestone was replaced with cementitious powder to reduce the volume of construction waste as well as the emission of carbon dioxide caused by Tal-carbonate reaction. The research found that cementitious powder can be used as a substitute for limestone. However, the mix proportions of fine aggregate and powder included in the cementitious powder appear to have a great effect on substitution. Thus, future research should focus on developing a technology that can effectively separate and discharge fine aggregate and powder in the cementitious powder.

Keywords: waste cementitious powder, fine aggregate powder, CO2 emission, decarbonation reaction, calcining process

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12026 Utilization of Waste Marble Dust as a Viscosity Modifying Agent in Self Compacting Concrete

Authors: Shams Ul Khaliq, Mushtaq Zeb, Fawad Bilal, Faizan Akbar, Syed Aamir Abbas

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Self Compacting Concrete as the name implies--is the concrete requiring a very little or no vibration to fill the form homogeneously. Self Compacting Concrete (SCC) is defined by two primary properties: Ability to flow or deform under its own weight (with or without obstructions) and the ability to remain homogeneous while doing so. Flow ability is achieved by utilizing high range water reducing admixtures and segregation resistance is ensured by introducing a chemical viscosity modifying admixture (VMA) or increasing the amount of fines in the concrete. The study explores the use waste marble dust (WMD) to increase the amount of fines and hence achieve self-compatibility in an economical way, suitable for Pakistani construction industry. The study focuses on comparison of fresh properties of SCC containing varying amounts of waste marble dust (WMD) with that containing commercially available viscosity modifying admixture. The comparison is done at different dosages of super plasticizer keeping cement, water, coarse aggregate, and fine aggregate contents constant.

Keywords: self compacting concrete, waste marble dust (WMD), flow ability, segregation resistance

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12025 Disposal Behavior of Extreme Poor People Living in Guatemala at the Base of the Pyramid

Authors: Katharina Raab, Ralf Wagner

Abstract:

With the decrease of poverty, the focus on the solid waste challenge shifts away from affluent, mostly Westernized consumers to the base of the pyramid. The relevance of considering the disposal behavior of impoverished people arises from improved welfare, leading to an increase in consumption opportunities and, consequently, of waste production. In combination with the world’s growing population the relevance of the topic increases, because solid waste management has global impacts on consumers’ welfare. The current annual municipal solid waste generation is estimated to 1.9 billion tonnes, 30% remains uncollected. As for the collected 70% is landfilling and dumping, 19% is recycled or recovered, 11% is led to energy recovery facilities. Therefore, aim is to contribute by adding first insights about poor people's disposal behaviors, including the framing of their rationalities, emotions and cognitions. The study provides novel empirical results obtained from qualitative semi-structured in-depth interviews near Guatemala City. In the study’s framework consumers have to choose from three options when deciding what to do with their obsolete possessions: Keeping the product: The main reason for this is the respondent´s emotional attachment to a product. Further, there is a willingness to use the same product under a different scope when it loses its functionality–they recycle their belongings in a customized and sustainable way. Permanently disposing of the product: The study reveals two dominant disposal methods: burning in front of their homes and throwing away in the physical environment. Respondents clearly recognized the disadvantages of burning toxic durables, like electronics. Giving a product away as a gift supports the integration of individuals in their peer networks of family and friends. Temporarily disposing of the product: Was not mentioned–to be specific, rent or lend a product to someone else was out of question. Contrasting the background to which extend poor people are aware of the consequences of their disposal decisions and how they feel about and rationalize their actions were quite unexpected. Respondents reported that they are worried about future consequences with impacts they cannot anticipate now–they are aware that their behaviors harm their health and the environment. Additionally, they expressed concern about the impact this disposal behavior would have on others’ well-being and are therefore sensitive to the waste that surrounds them. Concluding, the BoP-framed life and Westernized consumption, both fit in a circular economy pattern, but the nature of how to recycle and dispose separates these two societal groups. Both systems own a solid waste management system, but people living in slum-type districts and rural areas of poor countries are less interested in connecting to the system–they are primarily afraid of the costs. Further, it can be said that a consumer’s perceived effectiveness is distinct from environmental concerns, but contributes to forecasting certain pro-ecological behaviors. Considering the rationales underlying disposal decisions, thoughtfulness is a well-established determinant of disposition behavior. The precipitating events, emotions and decisions associated with the act of disposing of products are important because these decisions can trigger different results for the disposal process.

Keywords: base of the pyramid, disposal behavior, poor consumers, solid waste

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12024 Recovery of the Demolition and Construction Waste, Casablanca (Morocco)

Authors: Morsli Mourad, Tahiri Mohamed, Samdi Azzeddine

Abstract:

Casablanca is the biggest city in Morocco. It concentrates more than 60% of the economic and industrial activity of the kingdom. Its building and public works (BTP) sector is the leading source of inert waste scattered in open areas. This inert waste is a major challenge for the city of Casablanca, as it is not properly managed, thus causing a significant nuisance for the environment and the health of the population. Hence the vision of our project is to recycle and valorize concrete waste. In this work, we present concrete results in the exploitation of this abundant and permanent deposit. Typical wastes are concrete, clay and concrete bricks, ceramic tiles, marble panels, gypsum, scrap metal, wood . The work performed included: geolocation with a combination of artificial intelligence and Google Earth, estimation of the amount of waste per site, sorting, crushing, grinding, and physicochemical characterization of the samples. Then, we proceeded to the exploitation of the types of substrates to be developed: light cement, coating, and glue for ceramics... The said products were tested and characterized by X-ray fluorescence, specific surface, resistance to bending and crushing, etc. We will present in detail the main results of our research work and also describe the specific properties of each material developed.

Keywords: déchets de démolition et des chantiers de construction, logiciels de combinaison SIG, valorisation de déchets inertes, enduits, ciment leger, casablanca

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12023 An Innovation Decision Process View in an Adoption of Total Laboratory Automation

Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu

Abstract:

With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.

Keywords: innovation decision process, total laboratory automation, health care

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