Search results for: Safety compliance

Authors: A. Paz, M. Khadka, N. Veeramisti, B. Morris

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There is a continuous large number of crashes involving pedestrians in Nevada despite the numerous safety mechanisms currently used at roadway crossings. Hence, additional as well as more effective mechanisms are required to reduce crashes in Las Vegas, in particular, and Nevada in general. A potential mechanism to reduce conflicts between pedestrians and vehicles is a High-intensity Activated crossWalK (HAWK) signal. This study evaluates the effects of such signals at a particular site in Las Vegas. Video data were collected using two cameras, facing the eastbound and westbound traffic. One week of video data before and after the deployment of the signal were collected to capture the behavior of both pedestrians and drivers. T-test analyses of pedestrian waiting time at the curb, curb-to-curb crossing time, total crossing time, jaywalking events, and near-crash events show that the HAWK system provides significant benefits.

Keywords: pedestrian crashes, HAWK signal, traffic safety, pedestrian danger index

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Authors: Muhammad Arzim Naim, Saiful Azhar Rosly, Mohamad Sahari Nordin

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The objective of this study is to investigate the factors affecting the rise of Shariah non-compliance risk that can bring Islamic banks to succumb to monetary loss. Prior literatures have never analyzed such risk in details despite lots of it arguing on the validity of some Shariah compliance products. The Shariah non-compliance risk in this context is looking to the potentially failure of the facility to stand from the court test say that if the banks bring it to the court for compensation from the defaulted clients. The risk may also arise if the customers refuse to make the financing payments on the grounds of the validity of the contracts, for example, when relinquishing critical requirement of Islamic contract such as ownership, the risk that may lead the banks to suffer loss when the customer invalidate the contract through the court. The impact of Shariah non-compliance risk to Islamic banks is similar to that of legal risks faced by the conventional banks. Both resulted into monetary losses to the banks respectively. In conventional banking environment, losses can be in the forms of summons paid to the customers if they won the case. In banking environment, this normally can be in very huge amount. However, it is right to mention that for Islamic banks, the subsequent impact to them can be rigorously big because it will affect their reputation. If the customers do not perceive them to be Shariah compliant, they will take their money and bank it in other places. This paper provides new insights of risks faced by credit intensive Islamic banks by providing a new extension of knowledge with regards to the Shariah non-compliance risk by identifying its individual components that directly affecting the risk together with empirical evidences. Not limited to the Islamic banking fraternities, the regulators and policy makers should be able to use findings in this paper to evaluate the components of the Shariah non-compliance risk and make the necessary actions. The paper is written based on Malaysia’s Islamic banking practices which may not directly related to other jurisdictions. Even though the focuses of this study is directly towards to the Bay Bithaman Ajil or popularly known as BBA (i.e. sale with deferred payments) financing modality, the result from this study may be applicable to other Islamic financing vehicles.

Keywords: Islamic banking, Islamic finance, Shariah Non-compliance risk, Bay Bithaman Ajil (BBA), principal axis factoring

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Authors: Natalia Ortega

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Safety Culture (SCU) involves various perceptual, psychological, behavioral, and managerial factors. It has been shown that creating and maintaining an SCU is one way to reduce and prevent accidents and fatalities. In the construction sector, safety attitude, knowledge, and a supportive environment are predictors of safety behavior. The highest possible proportion of safety behavior among employees can be achieved by improving their safety attitude and knowledge. Accordingly, top management's commitment to safety is vital in shaping employees' safety attitude; therefore, the first step to improving employees' safety attitude is the genuine commitment of top management to safety. One of the factors affecting the successful implementation of health and safety promotion programs is the construction industry's subcontracting model. The contractual model's complexity, combined with the need for coordination among diverse stakeholders, makes it challenging to implement, manage, and follow up on health and well-being initiatives. The Systems theoretic accident model and process (STAMP) concept has expanded global consideration in recent years, increasing research attention. STAMP focuses attention on the role of constraints in safety management. The findings discover a growth of the research field from the definition in 2004 by Leveson and is being used across multiple domains. A systematic literature review of this novel model aims to meet the safety goals for human space exploration with a powerful and different approach to safety management, safety-driven design, and decision-making. Around two hundred studies have been published about applying the model. However, every single model for safety requires time to transform into research and practice, be tested and debated, and grow further and mature.

Keywords: stamp, risk management, accident prevention, safety culture, systems thinking, construction industry, safety

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Authors: Shinji Oouchi, Hajime Nomura, Kung-Da Wu, Jui-Pin Hung

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This paper presents the variation of the dynamic characteristics of a spindle with the change of bearing preload. The correlations between the variation of bearing preload and fundamental modal parameters were first examined by conducting vibration tests on physical spindle units. Experimental measurements show that the dynamic compliance and damping ratio associated with the dominating modes were affected to vary with variation of the bearing preload. When the bearing preload was slightly deviated from a standard value, the modal frequency and damping ability also vary to different extent, which further enable the spindle to perform with different compliance. For the spindle used in this study, a standard preload value set on bearings would enable the spindle to behave a higher stiffness as compared with others with a preload variation. This characteristic can be served as a reference to examine the variation of bearing preload of spindle in assemblage or operation.

Keywords: dynamic compliance, bearing preload, modal damping, standard preload

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Authors: Saurav Dhawan, Sanchit Bansal

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Background T-MACS is a computer-based decision aid that ‘rules in’ and ‘rules out’ ACS using a combination of the presence or absence of six clinical features with only one biomarker measured on arrival: hs-cTnT. T-MACS had 99.3% negative predictive value and 98.7% sensitivity for ACS, ‘ruling out’ ACS in 40% of patients while ‘ruling in’ 5% at the highest risk. We aim at benchmarking the use of T-MACS which could help to conserve healthcare resources, facilitate early discharges, and ensure safe practice. Methodology Randomized retrospective data collection (n=300) was done from ED electronic records across 3 hospital sites within MFT over a period of 2 months. Data was analysed and compared by percentage for the usage of T-MACS, number of admissions/discharges, and in days for length of stay in hospital. Results MRI A&E had the maximum compliance with the use of T-MACS in the trust at 66%, with minimum admissions (44%) and an average length of stay of 1.825 days. NMG A&E had an extremely low compliance rate (8 %), with 75% admission and 3.387 days as the average length of stay. WYT A&E had no TMACS recorded, with a maximum of 79% admissions and the longest average length of stay at 5.07 days. Conclusion All three hospital sites had a RAG rating of ‘RED’ as per the compliance levels. The assurance level was calculated as ‘Very Limited’ across all sites. There was a positive correlation observed between compliance with TMACS and direct discharges from ED, thereby reducing the average length of stay for patients in the hospital.

Keywords: ACS, discharges, ED, T-MACS

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Authors: Amira A. Alshowkan, Aleya M. Gamal

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Background: Patient safety is a vital element in providing high quality health care. In psychiatric wards, numerous of physical and emotional factors have been found to affect patient safety. In addition, organization, healthcare provider and patients were identified to be significant factors in patient safety. Aim: This study aims to discover nurses' perception of patient safety in psychiatric wards in Saudi Arabian. Method: Date will be collected through semi-structure face to face interview with nurses who are working at psychiatric wards. Data will be analysed thought the used of thematic analysis. Results: The results of this study will help in understanding the psychiatric nurses' perception of patient safety in Saudi Arabia. Several suggestions will be recommended for formulation of policies and strategies for psychiatric wards. In addition, recommendation to nursing education and training will be tailored in order to improve patient safety culture.

Keywords: patient safety culture, psychiatric, qualitative, Saudi Arabia

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Authors: Erwin L. Descallar

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Food safety is crucial in protecting the health of consumers, maintaining integrity in the entire food industry, and ensuring regulatory compliance. Food is a universal need for survival, and everyone is at risk of engaging in improper food handling, which increases vulnerability to foodborne illnesses. The level of knowledge or awareness and meat storage practices of students are behaviors influenced by various demographic factors. The Health Belief Model examines the relationship of such demographic factors towards the attitude, perception, and actions of individuals on perceived risk. This study aims to analyze and understand the correlation of said behaviors with course programs, prior food poisoning experience, and food handling of university students. The study employed randomized responses from 89 university students (n=89) under the College of Science at the Polytechnic University of the Philippines–Sta. Mesa (Manila). The results were subjected to measures of central tendency for score ranking and inferential statistics. The statistics were compared using Pearson ‘r’ Product Moment Correlation to determine the degree of relationship between the knowledge and practices on meat storage and safety. No statistically significant differences were found between the course program of students, food poisoning experiences, level of knowledge, and awareness regarding proper meat storage practices. However, increased frequency and involvement in meat handling have shown a positive correlation, indicating that there is a correlation between food handling and proper meat storage practices of university students.

Keywords: meat storage practices, food handling, food safety, meat science and technology

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Authors: C. Ah Gang Getrude, Iqbal Hashmi Shazia, Mohd Nawi Nurul Hudani

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This study examined the effectiveness of a Traffic Psychology Workshop in enhancing positive attitudes towards road safety awareness among youths. We predicted that youths’ attitudes towards road safety would be more positive after they participated in the one-day workshop. We examined their attitudes towards road safety awareness before and after they attended a one-day workshop. There were 21 participants who completed the pre and post-studies (9 males & 12 females, mean age 22.86, SD=2.03). A Wilcoxon signed-ranks test showed that the mean for post-test ranks for students’ attitudes towards road safety awareness was higher than the mean pre-test ranks, z =-3.16, p = .00. The study showed that the Traffic Psychology Module which focuses on the three elements: i) personality & emotion; Sensation, perception and visual; and mental workload could have positive effects on youths’ attitudes towards road safety awareness. We believe that the Traffic Psychology Module could be used as a guide by relevant authorities, such as the Sabah Road Safety Department, in implementing road safety awareness workshops and programs for the public, particularly road-users.

Keywords: attitude, road safety, traffic psychology, youth

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Authors: Natnicha Wareesamarn, Waruntorn Jongrungrotsakul, Anon Wisutthananon

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Occupational illnesses and injuries are the partial results of unsafe work behaviors. Safety training, an occupational health and safety standard, could either reduce or prevent such illnesses and injuries. This quasi-experimental research aimed to examine the effect of integrated safety training on safety work behaviors among 54 waste collectors working in the Su-ngai Kolok and Muang districts in Narathiwat Province. The workers were equally divided into an experimental or a control group (27 in each). The study was implemented from September to November 2021. The research instruments consisted of 1) an integrated safety promotion program on safety work behaviors which was developed based on the literature review, and 2) a questionnaire on safe working behaviors among waste collectors modified from a safety work behaviors questionnaire by Sitthichai Jaikhan et al. (2019). The content validity of the questionnaire was confirmed by experts with a content validity index of 0.97, while reliability was at an acceptable level (0.86 - 0.90). Data were analyzed using descriptive statistics and a t-test. The findings showed that after receiving the integrated safety promotion program on safety work behaviors, the mean scores for safety work behaviors among the experimental group (x ̅ = 73.89, S.D.=1.12) were significantly higher than those of the control group (x ̅ = 47.93, S.D.= 2.45) (p<.001). Furthermore, it was found that the mean score for safety work behaviors among the experimental group after receiving the integrated safety promotion program (x ̅=73.89, S.D.= 2.45) was significantly higher than that before receiving the program (x ̅=47.85, S.D.= 2.16) (p<.001). These findings indicate that occupational health nurses and related staff should place great concern on the application of integrated safety promotion programs into their own work. This is anticipated to enhance safe work behaviors, thereby reducing occupational illnesses and injuries, as well as enhancing the quality of working life among waste collectors.

Keywords: integrated safety promotion program, safety work behaviors, waste collectors, safety training

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Authors: Kaous Samira

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The lack of hand hygiene can contribute to nosocomial infections, including Central-venous-catheter-related bloodstream infections (CRBSI). An investigation from severally hospitals examined the frequency of hand hygiene in an OR among perioperative staff members who did not perform a surgical scrub. Among 50 operations (120 hours) that were observed, only 2% of staff members performed hand hygiene practices upon entering the OR, and 8.4% of staff performed hand hygiene upon leaving the OR. In addition, when performing radial arterial catheter placement, 0% of staff members wore gloves. Another study (A1170) surveyed healthcare providers regarding hand hygiene compliance. All of the 107 providers surveyed agreed that they should maintain hand hygiene, and most respondents believed that their own compliance was high. The author suggests that the low compliance problem associated with hand hygiene worldwide is a behavioral one among healthcare providers that requires acknowledgment and change.

Keywords: aneshesia, investigation, IOP, SBP

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Authors: Omar Shakra

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This paper contains a huge number of benefits that we can use it in several places and times in fire safety protection in the Middle East especially in Egypt . People here in Egypt did not consider the safety and fire protection as important as it is. But on the other hand, its very important for them to contain the fire systems and safety in every facility, the companies , hospitals , police stations , and even the super markets must use the fire system. It makes the facility safe to the visitors while they are using it.From my point of view as the owner Fire Safety Company called Deluge Egypt , i can say that not all of the companies use the fire system protection according to the high cost they prefer to build their company without the protection, and this is make the building totally unsafe to be used from the visitors or client.So, i am looking for new methods and technology to invest in Egypt, and this is through attending this Conference and let the audiences know more about the services i provide and [to let them know about the importance of the Fire Safety in Egypt. The Objectives of my research 1- The system that i used in my Company. 2- The benefits of the Fire System Protection. 3-The importance of the Fire System and safety. 4-The use of the new Technologies. 5-The hardships that i found while having new deals with new clients.

Keywords: fire, system, protection, fire hydrants, security, alarms

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Authors: Hyun-E Yeom

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Patients’ views about the cause of hypertension may influence their present and proactive behaviors to regulate high blood pressure. This study aimed to examine the internal structure underlying the causal beliefs about hypertension and the influence of causal beliefs on self-care intention and medical compliance in Korean patients with hypertension. The causal beliefs of 145 patients (M age = 57.7) were assessed using the Illness Perception Questionnaire-Revised. An exploratory factor analysis was used to identify the factor structure of the causal beliefs, and the factors’ influence on self-care intention and medication compliance was analyzed using multiple and logistic regression analyses. The four-factor structure including psychological, fate-related, risk and habitual factors was identified and the psychological factor was the most representative component of causal beliefs. The risk and fate-related factors were significant factors affecting lower intention to engage in self-care and poor compliance with medication regimens, respectively. The findings support the critical role of causal beliefs about hypertension in driving patients’ current and future self-care behaviors. This study highlights the importance of educational interventions corresponding to patients’ awareness of hypertension for improving their adherence to a healthy lifestyle and medication regimens.

Keywords: hypertension, self-care, beliefs, medication compliance

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Authors: Enoch F. Sam, Kris Brijs, Stijn Daniels, Tom Brijs, Geert Wets

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Notwithstanding the growing body of literature that recognises the importance of personal safety to public transport (PT) users, it remains unclear what PT users consider regarding their safety. In this study, we explore the criteria PT users in Ghana use to assess bus safety. This knowledge will afford a better understanding of PT users’ risk perceptions and assessments which may contribute to theoretical models of PT risk perceptions. We utilised phenomenological research methodology, with data drawn from 61 purposively sampled participants. Data collection (through focus group discussions and in-depth interviews) and analyses were done concurrently to the point of saturation. Our inductive data coding and analyses through the constant comparison and content analytic techniques resulted in 4 code categories (conceptual dimensions), 27 codes (safety items/criteria), and 100 quotations (data segments). Of the number of safety criteria participants use to assess bus safety, vehicle condition, driver’s marital status, and transport operator’s safety records were the most considered. With each criterion, participants rightly demonstrated its respective relevance to bus safety. These findings imply that investment in and maintenance of safer vehicles, and responsible and safety-conscious drivers, and prioritization of passengers’ safety are key-targets for public bus/minibus operators in Ghana.

Keywords: safety evaluations, public bus/minibus, passengers, phenomenology, Ghana

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Authors: Siyathorn Khunon, Thanawit Buafai

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This paper aims to investigate management of beach safety with a focus on tourist drownings in Samui. The data collected in this investigation will then lead to the proposal of a practical management model suitable for use in Samui. Qualitative research was conducted in the following manner: nine stakeholders from local government organizations and tourism businesses were interviewed in-depth. Additionally, a best practice case study from Phuket was applied to analyze beach safety. Twelve foreign tourists were also interviewed. Then, a focus group comprised of 32 people was used to determine practical solutions for enhancing tourists’ safety on the beach in Samui. A steering committee to coordinate between public and private organizations was proposed to manage and enhance tourists’ safety. A practical model is proposed to increase the safety level of tourists in Samui

Keywords: beach safety, drowning, tourist, Samui

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Authors: Hideyuki Shintani, Ichiro Koshijima

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In Cyber Physical System (CPS), if there are a large number of persons in the process, a role of person in CPS might be different comparing with the one-man system. It is also necessary to consider how Human-in-The-Loop Cyber Physical Systems (HiTLCPS) ensure safety of each person in the loop process. In this paper, the authors discuss a system safety framework with an illustrative example with STAMP model to clarify what point for safety should be considered and what role of person in the should have.

Keywords: cyber-physical-system, human-in-the-loop, safety, STAMP model

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Authors: Hyun Chul Koag, Hyun-Sik Ahn

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In this paper, we propose a design approach for the safety mechanism of an actuator used in a commercial vehicle’s EPS system. As the number of electric/electronic system in a vehicle increases, the importance of the functional safety has been receiving much attention. EPS(Electric Power Steering) systems for commercial vehicles require large power than passenger vehicles, and hence, dual motor can be applied to get more torque. We show how to formulate the development process for the design of hardware and software of an EPS system using dual motors. A lot of safety mechanisms for the processor, sensors, and memory have been suggested, however, those for actuators have not been fully researched. It is shown by metric analyses that the target ASIL(Automotive Safety Integrated Level) is satisfied in the point of view of hardware of EPS controller.

Keywords: safety mechanism, functional safety, commercial vehicles, electric power steering

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Authors: A. Orlov, V. Rachkov

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The future of Nuclear Energetics is seen in fast reactors with inherent safety working in the closed nuclear fuel cycle. The concept of inherent safety, which lies in deterministic elimination of the most severe accidents due to inherent properties of the reactor rather than through building up engineered barriers, is a cornerstone of success in ensuring safety and economic efficiency of future Nuclear Energetics. The focus of this paper is one of the key elements of inherent safety - the lead coolant of a nuclear reactor. Advantages of lead coolant for reactor application, influence on safety are reviewed. BREST-OD-300 fast reactor, currently being developed in Russia withing the “Proryv” Project utilizes lead coolant and a special set of measures and devices, called technology of lead coolant that ensures safe operation in a wide range of temperatures. Here these technological elements are reviewed, and current progress in their development is discussed.

Keywords: BREST-OD-300. , fast reactor, inherent safety, lead coolant

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Authors: Mark E. Lokanan, Liz Lee

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This paper aims to examine the role of accountants as gatekeepers in anti-money laundering compliance in real estate transactions. The paper seeks to answer questions on ways in which accountants are involved in real estate transactions and mandatory compliance with regulatory authorities in Canada. The data for the study came from semi-structured interviews with accountants, lawyers, and government officials. Preliminary results reveal that there is a conflict between accountants’ obligation to disclose and loyalty to their clients. Accountants often do not see why they are obligated to disclose their clients' information to government agencies. The importance of the client in terms of the amount of revenue contributed to the accounting firm also plays a significant role in accountants' reporting decision-making process. Although the involvement of accountants in real estate purchase and sale transactions is limited to lawyers or notaries, they are often involved in designing financing schemes, which may involve money laundering activities. The paper is of wider public policy interests to both accountants and regulators. It is hard not to see Chartered Professional Accountant (CPA) Canada and government regulators using the findings to better understand the decision-making processes of accountants in their reporting practices to regulatory authorities.

Keywords: money laundering, real estate, disclosure, legislation, compliance

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Authors: Nadia Elouaer

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Tax revenue is the main state resource and one of the important variables in tax policy. Nevertheless, this resource is continually decreasing, so it is important to focus on the reasons for this decline. Several studies show that the taxpayer is reluctant to pay taxes, especially in countries at risk or in countries in transition, including Tunisia. This study focuses on the tax evasion behavior of a Tunisian taxpayer under the influence of his political beliefs, as well as the influence of different tax compliance variables. Using a questionnaire, a sample of 500 Tunisian taxpayers is used to examine the relationship between political beliefs and taxpayer affiliations and tax compliance variables, as well as the study of the causal link between political beliefs and fraudulent behavior. The data were examined using correlation, factor, and regression analysis and found a positive and statistically significant relationship between the different tax compliance variables and the tax evasion behavior. There is also a positive and statistically significant relationship between tax evasion and political beliefs and affiliations. The study of the relationship between political beliefs and compliance variables shows that they are closely related. The conclusion is to admit that tax evasion and political beliefs are closely linked, and the government should update its tax policy and modernize its administration in order to strengthen the credibility and disclosure of information in order to restore a relationship of trust between public authorities and the taxpayer.

Keywords: fiscal policy, political beliefs, tax evasion, taxpayer behavior

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Authors: N. Borjalilu, P. Rabiei, A. Enjoo

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Flight Data Monitoring (FDM) program assists an operator in aviation industries to identify, quantify, assess and address operational safety risks, in order to improve safety of flight operations. FDM is a powerful tool for an aircraft operator integrated into the operator’s Safety Management System (SMS), allowing to detect, confirm, and assess safety issues and to check the effectiveness of corrective actions, associated with human errors. This article proposes a model for safety risk assessment level of flight data in a different aspect of event focus based on fuzzy set values. It permits to evaluate the operational safety level from the point of view of flight activities. The main advantages of this method are proposed qualitative safety analysis of flight data. This research applies the opinions of the aviation experts through a number of questionnaires Related to flight data in four categories of occurrence that can take place during an accident or an incident such as: Runway Excursions (RE), Controlled Flight Into Terrain (CFIT), Mid-Air Collision (MAC), Loss of Control in Flight (LOC-I). By weighting each one (by F-TOPSIS) and applying it to the number of risks of the event, the safety risk of each related events can be obtained.

Keywords: F-topsis, fuzzy set, flight data monitoring (FDM), flight safety

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Authors: Aleksandra Dragojlov

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Since the election of Aleksandar Vučić and the Progressives, Serbia has witnessed a slow decline in media freedom, which has been worse than in the 1990s. Although the government adopted a package of three laws in August 2014 to bring the media landscape up to European standards, the implementation of the laws has been limited and marginal, with the progressives engaging in fake compliance. The adoption of the new media strategy for 2020-2025 in 2020 has not led to genuine domestic reform and compliance with EU conditionality. In fact, the EU Commission and journalists’ associations in Serbia have criticised the decline in Serbia’s media freedom citing continued attacks on journalists and indirect political and economic control through advertising and project co-financing, which continue to be features of the Serbian media landscape. In the absence of clear and credible EU conditionality, the decline of media freedom is in the eye of the beholder, where the gap between public engagements with Serbian politicians and the critical stance of progress reports regarding the degradation of the media have enabled Serbian elites to exploit this ambiguity to continue their strategy of fake compliance vis-a-vis rule of law. This study used a mixed methods approach combining both primary and secondary sources with those semi-structured interviews via Zoom, email, and in person with EU and Serbian officials and journalists. Our findings add to the studies where the lack of clear and credible conditionality has allowed Serbia politicians to exploit them in a manner that would suit their own interests, finding new means to retain their control over the media. We argued and concluded that it is this discrepancy between public engagements with Serbia and the progress reports in the area of freedom of expression that has not led to genuine domestic media reforms in Serbia and instead allowed Serbian elites to engage in a strategy of fake and even non-compliance towards media freedom conditionality.

Keywords: media freedom, EU conditionality, Serbia, fake compliance, EU integration, Chapter 23, justice and fundamental rights

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Authors: Upal Barua

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Crash risk at intersections is a critical safety issue. This paper examines the effectiveness of removing an existing off-set at an intersection by realignment, in reducing crashes. Empirical Bayes method was applied to conduct a before-and-after study to assess the effect of this safety improvement. The Transportation Safety Improvement Program in Austin Transportation Department completed several safety improvement projects at high crash intersections with a view to reducing crashes. One of the common safety improvement techniques applied was the realignment of intersection approaches removing an existing off-set. This paper illustrates how this safety improvement technique is applied at a high crash intersection from inception to completion. This paper also highlights the significant crash reductions achieved from this safety improvement technique applying Empirical Bayes method in a before-and-after study. The result showed that realignment of intersection approaches removing an existing off-set can reduce crashes by 53%. This paper also features the state of the art techniques applied in planning, engineering, designing and construction of this safety improvement, key factors driving the success, and lessons learned in the process.

Keywords: crash risk, intersection, off-set, safety improvement technique, before-and-after study, empirical Bayes method

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Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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Authors: Mohammed Asiri, Saleh Alsuwayt, Mohammed Bin Mugren, Abdulmalik Almufarrih, Tariq Alotaibi, Saad Almodameg

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Background: End-stage renal disease is a major public health concern with high incidence and mortality rate. Most of ESRD patients are on hemodialysis therapy which is a long-term treatment that disturbs patients’ lifestyle. As a result, he will be susceptible to develop psychiatric disorders like anxiety that may direct him to non-compliance on physician instructions and hemodialysis therapy. Although there are studies conducted on psychiatric issues in hemodialysis patients, but few studies focused on the effect of anxiety disorder and the patient’s compliance. Hence, we are interested in determining the prevalence of anxiety disorder among hemodialysis patients in Saudi Arabia, as well as in defining the correlation between anxiety disorder and compliance on physician instructions and hemodialysis therapy. We hypothesize that our study will show a higher prevalence of anxiety in hemodialysis patients than in general population. Also, we expect the anxiety to have a negative impact on their compliance. Methodology: We used a cross-sectional study design carried out at dialysis unit of four major hospitals in Riyadh, KSA. We interviewed 235 End Stage Renal Disease male and female patients who are on hemodialysis. We divided the patients into two categories according to their compliance. we used modified general questionnaire to get their demographic data, then we used a psychometric response scale called visual analog scale (VAS) to assess patient’s compliance to hemodialysis and physician’s instructions. Also, we used the Arabic validated version of the hospital anxiety and depression scale (HAD scale) used mainly for anxiety assessment. Results: The overall response rate was 54%. Respondents included 147 (62.6%) males and 88 (37.4%) females. The prevalence of anxiety among hemodialysis patients is 13.3%. According to visual analog scale, we found that 189 compliant patients and 45 non-compliant patients. For HAD scale, the mean ± standard deviation of the total score for females was (4.44 ± 4.7) and it’s higher than males which was 2.65 ± 3.08 (P-value= 0.002). The mean ± standard deviation of HAD score in the non-compliant group was (5.88  4.88) and it was higher than the compliant group (2.7  3.32) (P-value= 0.004). Among non-complaint group, 33.3% of anxious patients were males and 66.6% were females. There was a negative correlation between HAD score of anxiety and visual analog scale (R= - 0.285). Conclusion: We conclude that there is a high prevalence of anxiety among patients with End Stage Renal Disease that was higher in females with association of non-compliance to physician’s instructions and hemodialysis therapy.

Keywords: anxiety, end-stage renal disease, renal failure, anxiety disorder

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Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

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Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

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Authors: Swati Swati, Yuhang Chen, Robert Reuben

Abstract:

Coronary stents are devices resembling the shape of a tube which are placed in coronary arteries, to keep the arteries open in the treatment of coronary arterial diseases. Coronary stents are routinely deployed to clear atheromatous plaque. The stent essentially applies an internal pressure to the artery because its structure is cylindrically symmetrical and this may introduce some abnormalities in final arterial shape. The goal of the project is to develop segmented circumferential arterial compliance measuring devices which can be deployed (eventually) in vivo. The segmentation of the device will allow the mechanical asymmetry of any stenosis to be assessed. The purpose will be to assess the quality of arterial tissue for applications in tailored stents and in the assessment of aortic aneurism. Arterial distensibility measurement is of utmost importance to diagnose cardiovascular diseases and for prediction of future cardiac events or coronary artery diseases. In order to arrive at some generic outcomes, a preliminary experimental set-up has been devised to establish the measurement principles for the device at macro-scale. The measurement methodology consists of a strain gauge system monitored by LABVIEW software in a real-time fashion. This virtual instrument employs a balloon within a gelatine model contained in a split cylinder with strain gauges fixed on it. The instrument allows automated measurement of the effect of air-pressure on gelatine and measurement of strain with respect to time and pressure during inflation. Compliance simple creep model has been applied to the results for the purpose of extracting some measures of arterial compliance. The results obtained from the experiments have been used to study the effect of air pressure on strain at varying time intervals. The results clearly demonstrate that with decrease in arterial volume and increase in arterial pressure, arterial strain increases thereby decreasing the arterial compliance. The measurement system could lead to development of portable, inexpensive and small equipment and could prove to be an efficient automated compliance measurement device.

Keywords: arterial compliance, atheromatous plaque, mechanical symmetry, strain measurement

Procedia PDF Downloads 279

Authors: Preeda Sansakorn, Min An

Abstract:

In order to be capable of dealing with uncertainties, subjectivities, including vagueness arising in building construction projects, the application of fuzzy reasoning technique based on fuzzy set theory is proposed. This study contributes significantly to the development of a fuzzy reasoning safety risk assessment model for building construction projects that could be employed to assess the risk magnitude of each hazardous event identified during construction, and a third parameter of probability of consequence is incorporated in the model. By using the proposed safety risk analysis methodology, more reliable and less ambiguities, which provide the safety risk management project team for decision-making purposes.

Keywords: safety risk assessment, building construction safety, fuzzy reasoning, construction risk assessment model, building construction projects

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Authors: A. Alrasheed, I. Connerton

Abstract:

Providing patients with safe meals on a daily basis is one of the challenges in the healthcare sector. In Saudi Arabia matters related to food safety and hygiene have been the heart of the Ministry of Health (MOH) and Saudi Food and Drugs Authority (SFDA). The aim of this study is to examine the causes of inadequate implementation of food safety management systems such as HACCP in Riyadh’s MOH hospitals. By the law, food safety must be managed using a documented, HACCP based approach, and food handlers must be appropriately trained in food safety. Food handlers in Saudi Arabia are not required to provide a certificate or attend a food handling training course even in healthcare sectors. Since food safety and hygiene issues are of increasing importance for Saudi Arabian health decision makers, the SFDA has been established to apply food hygiene requirements in all food operations. It should be pointed out that the implications of food outbreaks on the whole society may potentially go beyond individual health impacts but also impact on the Nation’s health and bring about economic repercussions.

Keywords: food safety, patient, hospital, HACCP

Procedia PDF Downloads 872

Authors: Abdullah Tahir

Abstract:

The omission of regular medications in surgical patients poses a significant challenge in healthcare settings and is associated with increased morbidity during hospital stays. Human factors such as high workload, poor communication, and emotional stress are known to contribute to these omissions, particularly evident in the surgical assessment unit (SAU) due to its high patient burden and long wait times. This study aimed to quantify and address the issue by implementing targeted interventions to enhance compliance in prescribing regular medications for surgical patients at Stoke Mandeville Hospital, United Kingdom. Data were collected on 14 spontaneous days between April and May 2023, and the frequency of prescription omissions was recorded using a tally chart. Subsequently, informative posters were introduced in the SAU, and presentations were given to the surgical team to emphasize the importance of compliance in this area. The interventions were assessed using a second data collection cycle, again over 14 spontaneous days in May 2023. Results demonstrated an improvement from 40% (60 out of 150) to 74% (93 out of 126) of patients having regular medications prescribed at the point of clerking. These findings highlight the efficacy of frequent prompts and awareness-raising interventions in increasing workforce compliance and addressing the issue of prescription omissions in the SAU.

Keywords: prescription omissions, quality improvement, regular medication, surgical assessment unit

Procedia PDF Downloads 76