Search results for: equipment care and maintenance

Authors: Mekdelawit Teferi Alamirew

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As a practical tool, the Geographical information system (GIS) was used for data integration, collection, management, analysis, and output presentation in pavement mangement systems . There are many GIS techniques to improve the maintenance activities like Dynamic segmentation and weighted overlay analysis which considers Multi Criteria Decision Making process. The results indicated that the developed MPI model works sufficiently and yields adequate output for providing accurate decisions. Hence considering multi criteria to prioritize the pavement sections for maintenance, as a result of the fact that GIS maps can express position, extent, and severity of pavement distress features more effectively than manual approaches, lastly the paper also offers digitized distress maps that can help agencies in their decision-making processes.

Keywords: pavement, flexible, maintenance, index

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Authors: J. K. Visser, H. T. Malan

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A need exists to identify the sources of risks associated with the process automation systems within petrochemical companies or similar energy related industries. These companies use many different process automation technologies in its value chain. A crucial part of the process automation system is the information technology component featuring in the supervisory control layer. The ever-changing technology within the process automation layers and the rate at which it advances pose a risk to safe and predictable automation system performance. The age of the automation equipment also provides challenges to the operations and maintenance managers of the plant due to obsolescence and unavailability of spare parts. The main objective of this research was to determine the risk sources associated with the equipment that is part of the process automation systems. A secondary objective was to establish whether technology managers and technicians were aware of the risks and share the same viewpoint on the importance of the risks associated with automation systems. A conceptual model for risk sources of automation systems was formulated from models and frameworks in literature. This model comprised six categories of risk which forms the basis for identifying specific risks. This model was used to develop a questionnaire that was sent to 172 instrument technicians and technology managers in the company to obtain primary data. 75 completed and useful responses were received. These responses were analyzed statistically to determine the highest risk sources and to determine whether there was difference in opinion between technology managers and technicians. The most important risks that were revealed in this study are: 1) the lack of skilled technicians, 2) integration capability of third-party system software, 3) reliability of the process automation hardware, 4) excessive costs pertaining to performing maintenance and migrations on process automation systems, and 5) requirements of having third-party communication interfacing compatibility as well as real-time communication networks.

Keywords: distributed control system, identification of risks, information technology, process automation system

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Authors: Marimuthu Gurusamy

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In vibration analysis (with accelerometers) of rotating machines with rolling element bearing, the customers are interested to know the failure of the machine well in advance to plan the spare inventory and maintenance. But in real world most of the machines fails before the prediction of vibration analyst or Expert analysis software. Presently the prediction of failure is based on ISO 10816 vibration limits only. But this is not enough to monitor the failure of machines well in advance. Because more than 50% of the machines will fail even the vibration readings are within acceptable zone as per ISO 10816.Hence it requires further detail analysis and different techniques to predict the failure well in advance. In vibration Analysis, the velocity spectrum is used to analyse the root cause of the mechanical problems like unbalance, misalignment and looseness etc. The envelope spectrum are used to analyse the bearing frequency components, hence the failure in inner race, outer race and rolling elements are identified. But so far there is no correlation made between these two concepts. The author used both velocity spectrum and Envelope spectrum to analyse the machine behaviour and bearing condition to correlated the changes in dynamic load (by unbalance, misalignment and looseness etc.) and effect of impact on the bearing. Hence we could able to predict the expected life of the machine and bearings in the rotating equipment (with rolling element bearings). Also we used process parameters like temperature, flow and pressure to correlate with flow induced vibration and load variations, when abnormal vibration occurs due to changes in process parameters. Hence by correlation of velocity spectrum, envelope spectrum and process data with 20 years of experience in vibration analysis, the author could able to predict the rotating Equipment and its component’s deterioration and expected duration for maintenance.

Keywords: vibration analysis, velocity spectrum, envelope spectrum, prediction of deterioration

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Authors: Rasikha Ramanand, Priyanka Dixit

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Background: Continuum of maternal care which includes antenatal care, delivery care and postnatal care aids in averting maternal deaths. The objective of this paper is to identify the association between previous experiences of child death on Continuum of Care (CoC) of recent child. Further, the study aimed at understanding where the drop-out rate was high in the continuum. Methods: The study was based on the Nation-wide District Level Household and Facility Survey (DLHS-4) conducted during 2012-13, which provides information on antenatal care, delivery care, percentage of women who received JSY benefits, percentage of women who had any pregnancy, delivery, the place of delivery etc. The sample included women who were selected from the non-EAG states who delivered at least two children. The data were analyzed using SPSS 20.Binary Logistic regression was applied to the data in which the Continuum of Care (CoC) was the dependent variable while the independent variables were entered as the covariates. Results: A major finding of the study was the antenatal to delivery care period where the drop-out rates were high. Also, it was found that a large proportion of women did not receive any of the services along the continuum. Conclusions: This study has clearly established the relationship between previous history of child loss and continuum of maternal care.

Keywords: antenatal care, continuum of care, child loss, delivery care, India, maternal health care, postnatal care

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Authors: Pavel E. Mikriukov

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The demand for natural gas (NG) is increasing every year around the world, so it is necessary to produce and transport NG in large quantities. To solve this problem, liquefied natural gas (LNG) plants are used, using different equipment and different technologies to achieve the required LNG quality. To determine the best efficiency of the LNG liquefaction plant, it is necessary to analyze the equipment used in this process and identify other technological solutions for LNG production using more productive and energy-efficient equipment. Based on this, mathematical models of the technological process of the LNG plant were created, which are based on a two-circuit system of heat exchange equipment and a nitrogen isolated cycle for NG cooling. The final liquefaction of natural gas is performed on the construction of the basic principle of the Joule-Thompson effect. The pressure and temperature drop are considered on different types of equipment such as throttle valve, which was used in the basic scheme; turbo expander and supersonic separator, which act as new equipment, to be compared with the efficiency of the basic scheme of the unit. New configurations of LNG plants are suggested, which can be used in almost all LNG facilities. As a result of the analysis, it turned out that the turbo expander and the supersonic separator have comparatively equal potential in comparison with the baseline scheme execution on the throttle valve. A more rational method of selecting the technology and the equipment used for natural gas liquefaction can improve the efficiency of low-tonnage plants and reduce the cost of gas for own needs.

Keywords: gas liquefaction, gas, Joule-Thompson effect, LNG, low-tonnage LNG, supersonic separator, Throttle valve, turbo expander

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Authors: Lars A. L. Giske, Ola J. Mork, Emil Bjoerlykhaug

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The design of fish processing equipment greatly impacts how easy the cleaning process for the equipment is. This is a critical issue in fish processing, as cleaning of fish processing equipment is a task that is both costly and time consuming, in addition to being very important with regards to product quality. Even more, poorly cleaned equipment could in the worst case lead to contaminated product from which consumers could get ill. This paper will elucidate how equipment design changes could improve the work for the cleaners and saving money for the fish processing facilities by looking at a case for product design improvements. The design of fish processing equipment largely determines how easy it is to clean. “Design for cleaning” is the new hype in the industry and equipment where the ease of cleaning is prioritized gets a competitive advantage over equipment in which design for cleaning has not been prioritized. Design for cleaning is an important research area for equipment manufacturers. SeaSide AS is doing continuously improvements in the design of their products in order to gain a competitive advantage. The focus in this paper will be conveyors for internal logistic and a product called the “electro stunner” will be studied with regards to “Design for cleaning”. Often together with SeaSide’s customers, ideas for new products or product improvements are sketched out, 3D-modelled, discussed, revised, built and delivered. Feedback from the customers is taken into consideration, and the product design is revised once again. This loop was repeated multiple times, and led to new product designs. The new designs sometimes also cause the manufacturing processes to change (as in going from bolted to welded connections). Customers report back that the concrete changes applied to products by SeaSide has resulted in overall more easily cleaned equipment. These changes include, but are not limited to; welded connections (opposed to bolted connections), gaps between contact faces, opening up structures to allow cleaning “inside” equipment, and generally avoiding areas in which humidity and water may gather and build up. This is important, as there will always be bacteria in the water which will grow if the area never dries up. The work of creating more cleanable design is still ongoing, and will “never” be finished as new designs and new equipment will have their own challenges.

Keywords: cleaning, design, equipment, fish processing, innovation

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Adel A. Ghobbar, Varun Raman

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The Corrective maintenance of components and systems is a problem plaguing almost every industry in the world today. Train operators’ and the maintenance repair and overhaul subsidiary of the Dutch railway company is also facing this problem. A considerable portion of the maintenance activities carried out by the company are unscheduled. This, in turn, severely stresses and stretches the workforce and resources available. One possible solution is to have a robust preventive maintenance plan. The other possible solution is to plan maintenance based on real-time data obtained from sensor-based ‘Health and Usage Monitoring Systems.’ The former has been investigated in this paper. The preventive maintenance model developed for train operator will subsequently be extended, to tackle the unscheduled maintenance problem also affecting the aerospace industry. The extension of the model to the aerospace sector will be dealt with in the second part of the research, and it would, in turn, validate the soundness of the model developed. Thus, there are distinct areas that will be addressed in this paper, including the mathematical modelling of preventive maintenance and optimization based on cost and system availability. The results of this research will help an organization to choose the right maintenance strategy, allowing it to save considerable sums of money as opposed to overspending under the guise of maintaining high asset availability. The concept of delay time modelling was used to address the practical problem of unscheduled maintenance in this paper. The delay time modelling can be used to help with support planning for a given asset. The model was run using MATLAB, and the results are shown that the ideal inspection intervals computed using the extended from a minimal cost perspective were 29 days, and from a minimum downtime, perspective was 14 days. Risk matrix integration was constructed to represent the risk in terms of the probability of a fault leading to breakdown maintenance and its consequences in terms of maintenance cost. Thus, the choice of an optimal inspection interval of 29 days, resulted in a cost of approximately 50 Euros and the corresponding value of b(T) was 0.011. These values ensure that the risk associated with component X being maintained at an inspection interval of 29 days is more than acceptable. Thus, a switch in maintenance frequency from 90 days to 29 days would be optimal from the point of view of cost, downtime and risk.

Keywords: delay time modelling, unscheduled maintenance, reliability, maintainability, availability

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Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Diana Bardhi

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Road safety is an essential part of the economic and social development of any industrialized country. Decisions to maintain and improve the reliability, functionality of infrastructure structures can only be achieved through integrated road life cycle planning and management. There has always been a tendency to review road maintenance strategies, but there is still no serious and reliable administration due to not only insufficient funds but also problems in the proper reorganization of this system. The safety and performance of the road system depend on the ongoing activity of road maintenance management. For it to be effective, it is necessary to intervene before the degradation has caused irreparable damage or damage with a high economic cost of repairs. Investments in road infrastructure during 2006-2014 show that the life of these projects presents problems related to the maintenance and management of life cycle performance in a wide range of constituent elements. Maintenance planning includes various problems that depend on the degree of degradation of asphalt layers, the degree of damage to road structures (bridges, tunnels, culverts, and the economic planning of resources for their repair). The purpose of this study is first to provide a brief overview of the problems in the field of maintenance and life cycle management of road infrastructure investments, proposing ways to reorganize the sector of administration and maintenance of ongoing roads and secondly testing and evaluating the work and nature of standards of different types of road infrastructure projects, through a methodology consisting of a) development, b) data collection, and c) analysis.

Keywords: infrastructure, maintenance, depreciation, efficiency

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Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

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Authors: Maria Giovanna Pacifico

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Maintenance, in Italy, is not yet a consolidated practice despite the benefits that could come from. Among the main reasons, there are the lack of financial resources and personnel in the public administration and a general lack of knowledge about how to activate and to manage a prevented and programmed maintenance. The experimentation suggests that users and tourists could be involved in the maintenance process from the knowledge phase to the monitoring ones by using mobile devices. The goal is to increase the quality of Facility Management for cultural heritage, prioritizing usage needs, and limiting interference between the key stakeholders. The method simplifies the consolidated procedures for the Information Systems, avoiding a loss in terms of quality and amount of information by focusing on the users' requirements: management economy, user safety, accessibility, and by receiving feedback information to define a framework that will lead to predictive maintenance. This proposal was designed to be tested in the Archaeological Park of Pompeii on the state property asset.

Keywords: asset maintenance, key stakeholders, Pompeii, user requirement

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Authors: Mingwei Yi, Liujie Guo, Zongjun Pan, Xiang Lin, Xiaoming Yi

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With the rapid expansion of road construction mileage in China, the scale of road maintenance needs has concurrently escalated. As the service life of roads extends, the design of pavement repair and maintenance emerges as a crucial component in preserving the excellent performance of the pavement. The remaining service life of asphalt pavement structure is a vital parameter in the lifecycle maintenance design of asphalt pavements. Based on an analysis of pavement structural integrity, this study introduces a characterization and assessment of the remaining life of existing asphalt pavement structures. It proposes indicators such as the transverse crack spacing and the length of longitudinal cracks. The transverse crack spacing decreases with an increase in maintenance intervals and with the extended use of semi-rigid base layer structures, although this trend becomes less pronounced after maintenance intervals exceed 4 years. The length of longitudinal cracks increases with longer maintenance intervals, but this trend weakens after five years. This system can support the enhancement of standardization and scientific design in highway maintenance decision-making processes.

Keywords: structural integrity, highways, pavement evaluation, asphalt concrete pavement

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Authors: Sungho Kim, Jaechoul Shin, Yujin Baek

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In recent years, due to the environmental impacts and time factor, etc., various type of pavement deterioration is increasing rapidly such as crack, pothole, rutting and roughness degradation. The Ministry of Land, Infrastructure and Transport maintains regular pavement condition of the highway and the national highway using the pavement condition survey equipment and structural survey equipment in Korea. Local governments that maintain local roads, farm roads, etc. are difficult to maintain the pavement condition using the pavement condition survey equipment depending on economic conditions, skills shortages and local conditions such as narrow roads. This study presents a quantitative evaluation method of the pavement condition through the visual inspection to overcome these problems of roads managed by local governments. It is difficult to evaluate rutting and roughness with the naked eye. However, the condition of cracks can be evaluated with the naked eye. Linear cracks (m), area cracks (m²) and potholes (number, m²) were investigated with the naked eye every 100 meters for survey the cracks. In this paper, crack ratio was calculated using the results of the condition of cracks and pavement condition was evaluated by calculated crack ratio. The pavement condition survey equipment also investigated the pavement condition in the same section in order to evaluate the reliability of pavement condition evaluation by the calculated crack ratio. The pavement condition was evaluated through the SPI (Seoul Pavement Index) and calculated crack ratio using results of field survey. The results of a comparison between 'the SPI considering only crack ratio' and 'the SPI considering rutting and roughness either' using the equipment survey data showed a margin of error below 5% when the SPI is less than 5. The SPI 5 is considered the base point to determine whether to maintain the pavement condition. It showed that the pavement condition can be evaluated using only the crack ratio. According to the analysis results of the crack ratio between the visual inspection and the equipment survey, it has an average error of 1.86%(minimum 0.03%, maximum 9.58%). Economically, the visual inspection costs only 10% of the equipment survey and will also help the economy by creating new jobs. This paper advises that local governments maintain the pavement condition through the visual investigations. However, more research is needed to improve reliability. Acknowledgment: The author would like to thank the MOLIT (Ministry of Land, Infrastructure, and Transport). This work was carried out through the project funded by the MOLIT. The project name is 'development of 20mm grade for road surface detecting roadway condition and rapid detection automation system for removal of pothole'.

Keywords: asphalt pavement maintenance, crack ratio, evaluation of asphalt pavement condition, SPI (Seoul Pavement Index), visual investigation

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Authors: Merve Aydin, Mağfiret Kara Kaşikçi

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Aim: To determine the perceptions of inpatients about care at Farabi Hospital in KTU. Material and Method: This research was conducted by using the universe known examples of formulas and probability selected by sampling method with 277 chosen patients in the hospital at least 14 days in other internal and surgical clinics except for pediatric, psychiatry, and intensive care unit services between January-March 2014 in KTU Farabi Hospital. The data was collected through the forms of nursing care perception scale of patients and defining characteristics of patients. In the evaluation of data, percentage, mean, Mann Whitney U, Student t and Kurskall Wallis tests were applied. Results: The average point the patients got in nursing care perception scale is 62.64±10.08’dir. 48.7 % of patients regard nursing care well and 36.8 % of them regard it very well. 19 % of the patients regard nursing care badly. When the age, sex, occupation, marital status, educational background, residential place, income level, hospitalization period, hospitalization clinic and having a hospital attendant were compared with nursing care perception average point, the difference among point averages was not found meaningful statistically (p > 0.05). The average point of nursing care perception was found greater in those having chronic disease (p < 0.05). Conclusion: The perception point of patients about nursing care is above the average according to the average of the lowest and highest points. The great majority of patients regard nursing care well or very well.

Keywords: hospital, patient, perception of nursing care, nursing care

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Authors: Nooshin Salari, Viliam Makis

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In this paper, we propose a condition-based maintenance policy for multi-unit systems considering the existence of economic dependency among units. We consider a system composed of N identical units, where each unit deteriorates independently. Deterioration process of each unit is modeled as a three-state continuous time homogeneous Markov chain with two working states and a failure state. The average production rate of units varies in different working states and demand rate of the system is constant. Units are inspected at equidistant time epochs, and decision regarding performing maintenance is determined by the number of units in the failure state. If the total number of units in the failure state exceeds a critical level, maintenance is initiated, where units in failed state are replaced correctively and deteriorated state units are maintained preventively. Our objective is to determine the optimal number of failed units to initiate maintenance minimizing the long run expected average cost per unit time. The problem is formulated and solved in the semi-Markov decision process (SMDP) framework. A numerical example is developed to demonstrate the proposed policy and the comparison with the corrective maintenance policy is presented.

Keywords: reliability, maintenance optimization, semi-Markov decision process, production

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Authors: Arielle Ferdinand

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A plant-based diet focuses on foods from plant sources, limiting or altogether omitting animal products. Some of the most common chronic illnesses seen in primary care are hypertension, hyperlipidemia, and diabetes type II. These common chronic illnesses can often be debilitating, costly, time-consuming, and, when left untreated, can lead to an early death. Treatment and maintenance of care are also labor intensive for the patient. They are often required to have at least four blood pressure checks yearly and a hemoglobin A1C checked quarterly. Though preventative interventions and prevention education should be included in patient visits in the primary care setting, education about dietary interventions, such as a plant-based diet, also yields positive outcomes for patients who already have hypertension, hyperlipidemia, and diabetes mellitus type 2. Evidence will show that incorporating a plant-based diet results in decreased blood pressure, as well as decreased levels of LDL-C, improved post-prandial glucose levels, and a reduction in HbA1C. It is cost-effective for the patient by generally lower grocery costs, and it can either reduce or prevent the need to pay for more office visits and pharmacotherapy. Incorporating this method of dietary changes is an easy intervention during a primary care office visit that would greatly benefit the patient in many ways.

Keywords: plant-based, nutrition, diabetes, hyperlipidemia

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Authors: Ashleigh Medina

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Chronic conditions account for the majority of total health care spending both in the United States and globally. Encouraging self-management to improve chronic conditions, which in turn could decrease the strain placed on hospitals, requires resources to address the patient’s social concerns in addition to their medical concerns. Transitional care has been identified as a possible bridge between acutely managing conditions at the hospital to chronically managing conditions in a community setting. The aim of this integrative review was to examine the impact of transitional care on self-management outcomes of chronic conditions in un/underinsured populations. Both transitional care, by assisting with resources such as funding sources for healthcare and medications or identifying a healthcare provider for continued care, and self-management, by increasing responsibility for one’s care through goal setting and taking action, can impact health outcomes while providing health care cost-savings.

Keywords: chronic conditions, self-management, transitional care, uninsured

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Authors: Sedigheh Salemi, Mahnaz Sanjari, Maryam Aalaa, Mohammad Mirzabeigi

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Clinical governance is the framework within which the health service provider is required to ongoing accountability and improvement of the quality of their services. This cross-sectional study was conducted in 661 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 24 questions in which 4 questions focused on clinical governance defining from the nurses' perspective. The reliability was evaluated by Cronbach's alpha (α=0/83). Statistical analyzes were performed, using SPSS version 16. Approximately 40% of nurses correctly answered that clinical governance is not "system of punishment and rewards for the staff". The most nurses believed that "clinical efficacy" is one of the main components of clinical governance. A few of nurses correctly responded that "Evidence Based Practice" and "management" is not part of clinical governance. The small number of nurses correctly answered that the "maintenance of patient records" and "to recognize the adverse effects" is not the role of nurse in clinical governance. Most "do not know" answer was to the "maintenance of patient records". The most nurses unanimously believed that the implementation of clinical governance led to "promoting the quality of care". About a third of nurses correctly stated that the implementation of clinical governance will not lead to "an increase in salaries and benefits of the medical team". As a member of the health team, nurses are responsible in terms of participation in quality improvement and it is necessary to create an environment in which clinical care will flourish and serve to preserve the high standards.

Keywords: clinical governance, nurses, salary, health team

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Authors: Jalal Soleimannejad, Mohammad Asadizeidabadi, Mahmoud Koorki, Mojtaba Azarpira

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A significant percentage of production costs is the maintenance costs, and analysis of maintenance costs could to achieve greater productivity and competitiveness. With this is mind, the maintenance of machines and installations is considered as an essential part of organizational functions and applying effective strategies causes significant added value in manufacturing activities. Organizations are trying to achieve performance levels on a global scale with emphasis on creating competitive advantage by different methods consist of RCM (Reliability-Center-Maintenance), TPM (Total Productivity Maintenance) etc. In this study, increasing the capacity of Concentration Plant of Golgohar Iron Ore Mining & Industrial Company (GEG) was examined by using of reliability and maintainability analyses. The results of this research showed that instead of increasing the number of machines (in order to solve the bottleneck problems), the improving of reliability and maintainability would solve bottleneck problems in the best way. It should be mention that in the abovementioned study, the data set of Concentration Plant of GEG as a case study, was applied and analyzed.

Keywords: bottleneck, golgohar iron ore mining & industrial company, maintainability, maintenance costs, reliability

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Authors: Jennifer Jackson

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Critical care nurses are at risk for burnout when confronted with sustained workplace adversity, which stems from a variety of social, structural, and environmental factors. Researchers have suggested that nurses can become resilient and overcome workplace adversity to achieve positive outcomes. The purpose of this study is to learn more about critical care nurses’ experiences with workplace adversity, and their process of becoming resilient. The research question will be: what is the process of critical care nursing resilience in workplace adversity? In-depth interviews with critical care nurses will provide the data to inductively generate the grounded theory. The resultant grounded theory will provide a framework to inform nurses and managers in developing interventions to support critical care nurses in their workplace. By enhancing nursing resilience, burnout may be avoided, and nurse satisfaction and overall quality of care may be improved.

Keywords: nursing, resilience, burnout, critical care

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Authors: Elena Ivany, Leanne Aitken

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Little is known about the delivery of end-of-life care in cardiac intensive care unit (CICU) settings. The aims of this study were to highlight the nurse-identified barriers and facilitators to delivering end-of-life care in the CICU, and to identify whether any of the barriers and/or facilitators are specific to the CICU setting. This was an exploratory qualitative study utilizing semi-structured individual interviews as the data collection method and inductive thematic analysis to structure the data. Six CICU nurses took part in the study. Five key themes were identified, each theme including both barriers and facilitators. The five key themes are as follows: patient-centered care, emotional challenges, reaching concordance, nursing contribution and the surgical intensive care unit.

Keywords: end-of-life, cardiovascular disease, cardiac surgery, critical care

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Authors: Jisong Ryu, Woosik Lee, Yonggu Jang

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The paper discusses the process of establishing a reliable test bed for verifying the usability of Ground Penetrating Radar (GPR) exploration equipment based on an integrated underground spatial map in Korea. The aim of this study is to construct a test bed consisting of metal and non-metal pipelines to verify the performance of GPR equipment and improve the accuracy of the underground spatial integrated map. The study involved the design and construction of a test bed for metal and non-metal pipe detecting tests. The test bed was built in the SOC Demonstration Research Center (Yeoncheon) of the Korea Institute of Civil Engineering and Building Technology, burying metal and non-metal pipelines up to a depth of 5m. The test bed was designed in both vehicle-type and cart-type GPR-mounted equipment. The study collected data through the construction of the test bed and conducting metal and non-metal pipe detecting tests. The study analyzed the reliability of GPR detecting results by comparing them with the basic drawings, such as the underground space integrated map. The study contributes to the improvement of GPR equipment performance evaluation and the accuracy of the underground spatial integrated map, which is essential for urban planning and construction. The study addressed the question of how to verify the usability of GPR exploration equipment based on an integrated underground spatial map and improve its performance. The study found that the test bed is reliable for verifying the performance of GPR exploration equipment and accurately detecting metal and non-metal pipelines using an integrated underground spatial map. The study concludes that the establishment of a test bed for verifying the usability of GPR exploration equipment based on an integrated underground spatial map is essential. The proposed Korean-style test bed can be used for the evaluation of GPR equipment performance and support the construction of a national non-metal pipeline exploration equipment performance evaluation center in Korea.

Keywords: Korea-style GPR testbed, GPR, metal pipe detecting, non-metal pipe detecting

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Authors: Shuja Alharbi

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Oil and Gas industry has many applications considered as toxic or hazardous, where process fluid leakage is not permitted and leads to health, safety, and environmental impacts. Caustic/Acidic applications, High Benzene Concentrations, Hydrogen sulfide rich oil/gas as well as liquids operating above their auto-ignition temperatures are examples of such liquids that pose as a risk to the industry operation, and for those, special arrangements are in place to allow for the safe operation environment. Pumps in the industry requires special attention, specifically in the interface between the fluid and the environment, where the potential of leakages are foreseen. Mechanical Seals are used to contain the fluid within the equipment, but the prices are ever increasing for such seals, along with maintenance, design, and operating requirements. Several alternatives to seals are being employed nowadays, such as Sealless systems, which is hermitically sealed from the atmosphere and does not require sealing. This technology is considered relatively new and requires more studies to understand the limitations and factors associated from an owner and design perspective. Things like financial factors, maintenance factors, and design limitation should be studies further in order to have a mature and reliable technical solution available to end users.

Keywords: pump, sealless, selection, failure

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Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: elder care settings, family caregiver, home care, geriatric hospital care, long term care facility

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Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Holistic and patient-centred palliative care and support require an integrated system of care that includes health and social service providers working together to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the benefits and challenges of mobilizing multidisciplinary care teams for health care professionals and social service providers. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed, and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers posed by multidisciplinary care teams. Three main findings emerged: First, the data highlighted the benefits of multidisciplinary care teams for both patient outcomes and quality of life and provider mental health; second, the data showed that the lack of a system-wide integrated communication system reduces the quality of patient care and increases provider stress while working in multidisciplinary care teams; finally, the data demonstrated the existence of implicit hierarchies between disciplines, this coupled with different disciplinary perspectives of palliative care provision can lead to friction and challenges within care teams. These findings will have important implications for the future of palliative care as they will help to facilitate and build stronger person-centred/relationship-centred palliative care practices by naming the challenges faced by multidisciplinary palliative care teams and providing examples of best practices.

Keywords: public health palliative care, palliative care nursing, care networks, integrated health care, palliative care approach, public health, multidisciplinary work, care teams

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Authors: C. M. Sapkota, B. P. Sapkota

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Background: Continuous developments in science and technology are increasing the availability of thousands of medical devices – all of which should be of good quality and used appropriately to address global health challenges. It is obvious that bio medical devices are becoming ever more indispensable in health service delivery and among the key workforce responsible for their design, development, regulation, evaluation and training in their use: biomedical technician (BMET) is the crucial. As a pivotal member of health workforce, biomedical technicians are an essential component of the quality health service delivery mechanism supporting the attainment of the Sustainable Development Goals. Methods: The study was based on cross sectional descriptive design. Indicators measuring the quality of health services were assessed in Mechi Zonal Hospital (MZH) and Sagarmatha Zonal Hospital (SZH). Indicators were calculated based on the data about hospital utilization and performance of 2018 available in Medical record section of both hospitals. MZH had employed the BMET during 2018 but SZH had no BMET in 2018.Focus Group Discussion with health workers in both hospitals was conducted to validate the hospital records. Client exit interview was conducted to assess the level of client satisfaction in both the hospitals. Results: In MZH there was round the clock availability and utilization of Radio diagnostics equipment, Laboratory equipment. Operation Theater was functional throughout the year. Bed Occupancy rate in MZH was 97% but in SZH it was only 63%.In SZH, OT was functional only 54% of the days in 2018. CT scan machine was just installed but not functional. Computerized X-Ray in SZH was functional only in 72% of the days. Level of client satisfaction was 87% in MZH but was just 43% in SZH. MZH performed all (256) the Caesarean Sections but SZH performed only 36% of 210 Caesarean Sections in 2018. In annual performance ranking of Government Hospitals, MZH was placed in 1st rank while as SZH was placed in 19th rank out of 32 referral hospitals nationwide in 2018. Conclusion: Biomedical technicians are the crucial member of the human resource for health team with the pivotal role. Trained and qualified BMET professionals are required within health-care systems in order to design, evaluate, regulate, acquire, maintain, manage and train on safe medical technologies. Applying knowledge of engineering and technology to health-care systems to ensure availability, affordability, accessibility, acceptability and utilization of the safer, higher quality, effective, appropriate and socially acceptable bio medical technology to populations for preventive, promotive, curative, rehabilitative and palliative care across all levels of the health service delivery.

Keywords: biomedical equipment technicians, BMET, human resources for health, HRH, quality health service, rural hospitals

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Authors: Wim Zeiler

Abstract:

The indoor quality of occupied space is very important for the well-being of its occupants, especially in the case of babies. The lungs of a young child are still growing and adverse conditions could affect this development. Presently little children spend a lot of their time in day care centers while parents are at work. Little is known about the effects of different indoor environmental factors present in these day care centers and the quality of air of baby cots in which the babies are accommodated in these day care centers. Therefore this research investigated the quality of the accommodation of Dutch day care centers. Besides an extensive literature research actual measurements were performed in baby cots within three-day care center. Some experiments were performed to find out the importance of the configuration and types of baby cots. This research investigated the quality of the accommodation of a Dutch day care center which led to a tool describing the quality needs (e.g., quality standard) for the accommodation of day care centers. The results of our detailed studies were compared with the results of earlier Dutch more global studies in day care centers, in which more than 60 day care centers were investigated. Also the results are compared with the outcomes of research on school ventilation. The results proved that the situation in day care centers is even worse than that of schools within the Netherlands. More attention is needed to improve the current situation.

Keywords: ventilation, baby cots, day care centers, case study

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Authors: Ayman M. Othman, Hassan Y. Ahmed, Tallat A. Ali

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Inadequate maintenance programs and funds allocated for highway networks in the developed countries have led to fast deterioration of road side elements. Therefore, this research focuses on developing a performance model for road side elements periodic maintenance activities. Road side elements that receive periodic maintenance include; earthen shoulder, road signs and traffic markings. Using the level of service concept, the developed model can determine the optimal periodic maintenance intervals for those elements based on a selected level of service suitable with the available periodic maintenance budget. Data related to time periods for progressive deterioration stages for the chosen elements were collected. Ten maintenance experts in Aswan, Sohag and Assiut cities were interviewed for that purpose. Time in months related to 10%, 25%, 40%, 50%, 75%, 90% and 100% deterioration of each road side element was estimated based on the experts opinion. Least square regression analysis has shown that a power function represents the best fit for earthen shoulders edge drop-off and damage of road signs with time. It was also evident that, the progressive dirtiness of road signs could be represented by a quadratic function an a linear function could represent the paint degradation nature of both traffic markings and road signs. Actual measurements of earthen shoulder edge drop-off agree considerably with the developed model.

Keywords: deterioration, level of service, periodic maintenance, performance model, road side element

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Authors: Federico Pittino, Thomas Arnold

Abstract:

The shredding of waste materials is a key step in the recycling process towards the circular economy. Industrial shredders for waste processing operate in very harsh operating conditions, leading to the need for frequent maintenance of critical components. Maintenance optimization is particularly important also to increase the machine’s efficiency, thereby reducing the operational costs. In this work, a monitoring system has been developed and deployed on an industrial shredder located at a waste recycling plant in Austria. The machine has been monitored for one year, and methods for predictive maintenance have been developed for two key components: the cutting knives and the drive belt. The large amount of collected data is leveraged by statistical machine learning techniques, thereby not requiring very detailed knowledge of the machine or its live operating conditions. The results show that, despite the wide range of operating conditions, a reliable estimate of the optimal time for maintenance can be derived. Moreover, the trade-off between the cost of maintenance and the increase in power consumption due to the wear state of the monitored components of the machine is investigated. This work proves the benefits of real-time monitoring system for the efficient operation of industrial shredders.

Keywords: predictive maintenance, circular economy, industrial shredder, cost optimization, statistical machine learning

Procedia PDF Downloads 101