Work - Volume 41, issue Supplement 1

Authors: Bortot, Dino | Ding, Hao | Antonopolous, Alexandros | Bengler, Klaus

Article Type: Research Article

Abstract: Human workers and industrial robots both have specific strengths within industrial production. Advantageously they complement each other perfectly, which leads to the development of human-robot interaction (HRI) applications. Bringing humans and robots together in the same workspace may lead to potential collisions. The avoidance of such is a central safety requirement. It can be realized with sundry sensor systems, all of them decelerating the robot when the distance to the human decreases alarmingly and applying the emergency stop, when the distance becomes too small. As a consequence, the efficiency of the overall systems suffers, because the robot has high idle …times. Optimized path planning algorithms have to be developed to avoid that. The following study investigates human motion behavior in the proximity of an industrial robot. Three different kinds of encounters between the two entities under three robot speed levels are prompted. A motion tracking system is used to capture the motions. Results show, that humans keep an average distance of about 0,5m to the robot, when the encounter occurs. Approximation of the workbenches is influenced by the robot in ten of 15 cases. Furthermore, an increase of participants’ walking velocity with higher robot velocities is observed. Show more

Keywords: human-robot interaction, human-robot coexistence, human motion behavior, safety distance

DOI: 10.3233/WOR-2012-0372-1699

Citation: Work, vol. 41, no. Supplement 1, pp. 1699-1707, 2012

Authors: Górny, Adam

Article Type: Research Article

Abstract: The specific organizing the conditions of executing the job makes up the essential decisive about possibility obtainment element of competitive superiority. The ergonomic requirements are essential element of this process. They unite the environment of work with principles of the SCR, causing enlargement the man’s part in development of enterprise.

Keywords: ergonomics, work condition, environments load, CSR, human factor, human activity

DOI: 10.3233/WOR-2012-0373-1708

Citation: Work, vol. 41, no. Supplement 1, pp. 1708-1711, 2012

Authors: Figueira, Sara | Machado, V. Cruz | Nunes, Isabel L.

Article Type: Research Article

Abstract: Nowadays many companies are undergoing organizational transformations in order to meet the changing market demands. Thus, in order to become more competitive, supply chains (SC) are adopting new management paradigms to improve SC performance: lean, agile, resilient and green (LARG paradigms). The implementation of new production paradigms demands particular care with the issues related with Human Factors to avoid health and safety problems to workers and losses to companies. Thus, the successful introduction of these new production paradigms depends among others on a Human Factors oriented approach. This work presents a conceptual framework that allows integrating ergonomic and safety design …principles during the different implementation phases of lean, agile, resilient and green practices. Show more

Keywords: Supply chain, LARG paradigms, Conceptual framework, Human factors

DOI: 10.3233/WOR-2012-0374-1712

Citation: Work, vol. 41, no. Supplement 1, pp. 1712-1719, 2012

Authors: Zanatta, Mateus | Amaral, Fernando Gonçalves

Article Type: Research Article

Abstract: Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a …new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements. Show more

Keywords: human factors, volunteers, firefighters, setup time reduction, layout design

DOI: 10.3233/WOR-2012-0375-1720

Citation: Work, vol. 41, no. Supplement 1, pp. 1720-1726, 2012

Authors: Mottin, Artur Caron | Silva de Miranda, Carlos A. | Pagnan, Caroline Salvan | Monken, Olavo Pena

Article Type: Research Article

Abstract: Brazil is currently recognized as the 10th largest producer of castings, and the city of Cláudio, MG is known worldwide as the “Greatest foundry and metallurgical pole in Latin America”, with more than 80 companies. However, this large number of enterprises and increasing investments in product development has demanded an increase in manpower and working hours of workers in the sector, proportionally increasing the incidence of occupational related health problems like RSI (repetitive strain injury), WMSDs (work-related musculoskeletal disorders) and industrial accidents. This article aims to characterize the industry from previously conducted case studies to relate the main causes of …occupational diseases and outline possible interventions through design, showing how this tool can contribute to improve the working environment, workplace, tools and equipment through ergonomics adjustments. Show more

Keywords: ergonomics, design, workplace, casting

DOI: 10.3233/WOR-2012-0376-1727

Citation: Work, vol. 41, no. Supplement 1, pp. 1727-1732, 2012

Authors: Attaianese, Erminia | Duca, Gabriella

Article Type: Research Article

Abstract: Pharmaceutical plants are usually characterized by workplaces with quality levels generally higher than in other manufactoring sectors since healthcare products need to be produced in special conditions, keeping under a strong control hygiene, chemical and biological contaminants, and giving a particular emphasis on equipment maintenance. Limited physical work load, a low rate of injuries and work related pathologies together with a high level of quality process control contribute to consider pharma work conditions as generally light and safe. In this kind of contexts risk assessment cannot be based on factors individually considered, neither work load can be essentially measured on …material handling and physical effort. Risk assessment and work environment improvements, on the contrary, have to be studied by an integrated view point. The paper presents methodologies and results of the applied research project IntegrARE (INTEGRated Assessment of Risks within Ergonomics) aimed at analyzing, in a big solid forms pharmaceutical plant, three different risk categories - architectural, ergonomic and active pharmaceutical ingredients risks – in order to highlight possible interactions on workers health, safety and wellbeing. After a detailed risk situations survey, singularly analyzed by a number of ad-hoc procedures, the study presents a methodology for integrated assessment of risks, aimed at identifying and evaluating integrated effects increasing or triggering risk situations for workers. Show more

Keywords: architectural risk, ergonomic risk, active pharmaceutical ingredients, integrated risks, building

DOI: 10.3233/WOR-2012-0377-1733

Citation: Work, vol. 41, no. Supplement 1, pp. 1733-1738, 2012

Authors: Fialho, Patrícia Bhering | de Souza, Amaury Paulo | Minette, Luciano José | de Castro Silva, José | de Oliveira, Luciana Aparecida

Article Type: Research Article

Abstract: This study aimed to perform an ergonomic evaluation of industrial processes and products - upholstered sofas - produced in the furniture cluster of Ubá-MG. The used material was collected from two sofas upholstered industries associated with the union of the furniture industries of Ubá region, located in Minas Gerais estate, Brazil. As for the product were evaluated dimensionally 29 upholstered sofas, with 12 being produced by industry “A” and 17 being produced by industry “B”. As for the process, were evaluated: the socioeconomic profile of the worker and environmental factors of lighting and noise. The main results of this study …showed that the upholstered sofas produced by industries, in general, fulfilled to the recommendations set out in the work in relation to the backrest height and useful seat depth. All the sofas, however, proved to be inadequate in relation to the seat height to the floor and the dimensions of the armrests Regarding environmental aspects, it was observed that in both industries, the activities in most jobs are performed under adverse conditions to the health and safety of workers and nonconformity with the limits set by Brazilian regulatory standard used in this work. Show more

Keywords: sofa, furniture industry

DOI: 10.3233/WOR-2012-0378-1739

Citation: Work, vol. 41, no. Supplement 1, pp. 1739-1742, 2012

Authors: Renner, J.S. | de M. Guimarães, L.B. | de Oliveira, P.A.B.

Article Type: Research Article

Abstract: This article presents a macroergonomic intervention in a footwear company in Rio Grande do Sul, Brazil, to improve both the quality of life of the employees and productivity by optimizing the traditional Taylor/Ford work organization. Multi-functionality and team worki ng were implemented as means of making tasks more flexible and richer and the working hours were changed. The results showed a reduction in human and material resource costs and a consequent improvement in health and workers quality of life. Although middle managerial staff displayed strong resistance to the project and to breaking traditional production paradigms, the socio-technical system has been …implemented throughout the plant and is expected to end up becoming the benchmark for other companies in the sector. Keywords: Macro-ergonomics, footwear industry, organization work. Show more

DOI: 10.3233/WOR-2012-0379-1743

Citation: Work, vol. 41, no. Supplement 1, pp. 1743-1750, 2012

Authors: Forsman, Mikael | Bernmark, Eva | Nilsson, Birgitta | Pousette, Sandra | Mathiassen, Svend Erik

Article Type: Research Article

Abstract: Rationalizations generally have a negative effect on health and known risk factors for musculoskeletal disorders. These effects may be reduced by paying attention to modifiers as worker participation and a resonant management style. In this study a participatory approach was used in the food industry in order to improve ergonomics and productivity. The food industry shows a high prevalence of musculoskeletal disorders, and repetitive manual work occurs extensively. Prototypes of new packaging solutions were developed in three cases, and compared in a simulated production to the existing production system through direct measurements of working postures and muscle activity, ratings of …physical load, and general productivity data. Measured and rated ergonomic exposures showed that workload was significantly lower for the prototypes, in all three cases. In two cases, the number of handling operations included in the packaging operations were greatly reduced with the prototype package, as were production costs. The impact on disorders of the obtained load reductions is difficult to assess, but we believe that in “critical” situations like this, even small improvements may have an effect. This study shows that workloads during manual handling of packages as well as production costs can be reduced by applying participative development of packages. Show more

Keywords: packages, productivity, inclinometry, goniometry, electromyography

DOI: 10.3233/WOR-2012-0380-1751

Citation: Work, vol. 41, no. Supplement 1, pp. 1751-1755, 2012

Authors: Vieira, Leandro | Balbinotti, Giles | Varasquin, Adriano | Gontijo, Leila

Article Type: Research Article

Abstract: With increased international competitiveness in the automotive industry, came the concern of the companies save costs and lower production costs. For this purpose many ways are designed to reduce costs and waste of raw materials and reduce activities that do not aggregate value to manufacturing processes. In the early XVII appears the manufacturing system, which processes were hard with little concern for the health and safety of employees and conditions of the workplace. After the advent of the production system called lean manufacturing, a new paradigm in terms of production system capable of providing high levels of productivity and quality. …It is based on waste elimination that occur during the production process. After began a new way of thinking, creating a culture of continuous improvement and lean process with no waste and reducing costs, without neglecting the welfare worker and improving the conditions of their work environment. This paper presents a reflection on the application of ergonomics in a lean production system of an automotive industry, using methodology based on the Kaizen (Continuous Improvement) to gain performance and improving the conditions of the workplace, also will be presented with positive and negative points in using this methodology in relation to ergonomics. The research will be conducted by collecting data ‘in loco’ and interviews with workers. Some studies show that in companies that are lean system and using the methodology of Kaizen, the results of product quality, levels of absenteeism and accidents are better than those obtained in companies that do not apply the same concept. Show more

Keywords: working condition, lean manufacturing, performance, methodology, indicators

DOI: 10.3233/WOR-2012-0381-1756

Citation: Work, vol. 41, no. Supplement 1, pp. 1756-1762, 2012

Authors: Greensword, Marlon | Aghazadeh, Fereydoun | Al-Qaisi, Saif

Article Type: Research Article

Abstract: Although track and field spike shoes are crafted for runners, these shoes are not designed for regular walking. With such shoes, runners may eventually encounter serious chronic injuries such as plantar fasciitis, shin splints, achilles tendinitis, chondromalacia, and iliotibial band syndrome. To address this problem, a modified spike shoe was tested and compared to a regular spike shoe. The modification consists of adding a removable heel to the shoe sole in order to reduce the flexion of the foot and properly level the foot for walking. Nine healthy participants performed walking drills at 2 and 3 mph, using the original …and the modified shoes. Electromyography (EMG) measurements were used to evaluate muscle activities. Participants also rated their discomfort on a 0-10 scale. Results show that the use of modified shoes resulted in a reduction of 22% and 24.25% EMG activity for the tibialis and gastrocnemius muscles, respectively. Comfort ratings increased by an average of 2.7, 2.6, 3.9, and 4.2 points at the knees, calves, ankles, and feet, respectively. Show more

Keywords: Running injuries, sports ergonomic, running gear, EMG, track and field

DOI: 10.3233/WOR-2012-0382-1763

Citation: Work, vol. 41, no. Supplement 1, pp. 1763-1770, 2012

Authors: Salles, André S. | Gyi, Diane E.

Article Type: Research Article

Abstract: Research has been conducted to explore a process that delivers insoles for personalised footwear for the high street using additive manufacturing (AM) and to evaluate the use of such insoles in terms of discomfort. Therefore, the footwear personalisation process was first identified: (1) foot capture; (2) anthropometric measurements; (3) insole design; and (4) additive manufacturing. In order to explore and evaluate this process, recreational runners were recruited. They had both feet scanned and 15 anthropometric measurements taken. Personalised insoles were designed from the scans and manufactured using AM. Participants were fitted with footwear under two experimental conditions: personalised and control, …which were compared in terms of discomfort. The mean ratings for discomfort variables were generally low for both conditions and no significant differences were detected between conditions. In general, the personalisation process showed promise in terms of the scan data, although the foot capture position may not be considered ‘gold standard’. Polyamide, the material used for the insoles, demonstrated positive attributes: visual inspection revealed no signs of breaking. The footwear personalisation process described and explored in this study shows potential and can be considered a good starting point for designer and researchers. Show more

Keywords: 3D scanning, anthropometry, footwear

DOI: 10.3233/WOR-2012-0383-1771

Citation: Work, vol. 41, no. Supplement 1, pp. 1771-1774, 2012

Authors: Yanes Escalona, L | Sandia Venot, R | Escalona, E | Yanes, L

Article Type: Research Article

Abstract: Objective: intervene a workline throughout ergonomic approach to diminish incidence of Carpal Tunnel Syndrome (CTS). Methods and Materials: an ergonomic intervention study was developed in workstations with highest index of musculoskeletal disorder (MED) associated to cumulative trauma. The Deparis method, Reba and Ocra check list methods were used, also morbility reviewes. National and international ethics criteria were carried out. Results: workers identified 3 fundamental issues using the Deparis method: repetitive activities, postures adopted and uncomfortable furniture. The analysis of the workstation with Reba and Ocra methods before the changes, evidenciated that 56% of postures adopted were high risk postures, the …44% remaining were medium and low-risk. Following the active pause program (APP), furniture changes and work rhythm decrease, was noted that the risk of suffering MED decreased. The morbility review, drop in consults of muscleskeletal system (MES) related to CTS observed. The APP was well accepted by women, but not initially men. Discussion: the research show that when the work rhythm decreases, the symptom of MES related to CTS have a remarkable decrease, also that changes in the furniture, generate great ergonomic differences and changes in the work environment are not possible if workers don’t empower the tools to make-it. Show more

Keywords: ergonomics, cumulative trauma disorders, carpal tunnel syndrome, electric motors assembly

DOI: 10.3233/WOR-2012-0384-1775

Citation: Work, vol. 41, no. Supplement 1, pp. 1775-1777, 2012

Authors: Mühlemeyer, C | Klussmann, A | Gebhardt, H | Lang, KH

Article Type: Research Article

Abstract: Research activities to determine the need of recovery time at work were mainly performed in the 1970s and 1980s. Previous studies were largely based on expert opinions or were generated within small and non-representative groups. Often, laboratory experiments were carried out with a low number of subjects. Especially during the last decade, only little additional scientific knowledge was generated on this topic. The very resource intensive development of more detailed results based on the existing level of scientific knowledge is assumed as one reason for this. In general, it seems to be reasonable to continue further research on the knowledge …generated in previous studies, but implement larger samples and more representative groups. Besides, according to monotonous manual work, more research is especially needed regarding relative operating forces and operation frequencies taken grip conditions and hand/body position into account. Show more

Keywords: muscle-work, monotonous tasks, cognitive demands, fatigue, recovery time

DOI: 10.3233/WOR-2012-0385-1778

Citation: Work, vol. 41, no. Supplement 1, pp. 1778-1781, 2012

Authors: Maldonado-Macías, A | Reyes, R | Guillen, L | García, J

Article Type: Research Article

Abstract: Advanced Manufacturing Technology (AMT) is one of the most relevant resources that companies have to achieve competitiveness and best performance. The selection of AMT is a complex problem which involves significant amount of information and uncertainty when multiple aspects must be taken into consideration. Actual models for the selection of AMT are found scarce of the Human Factors and Ergonomics perspective which can lead to a more complete and reliable decision. This paper presents the development of software that enhances the application of an Ergonomic Compatibility Evaluation Model that supports decision making processes taking into consideration ergonomic attributes of designs. …Ergonomic Compatibility is a construct used in this model and it is mainly based in the concept of human-artifact compatibility on human compatible systems. Also, an Axiomatic Design approach by the use of the Information Axiom was evolved under a fuzzy environment to obtain the Ergonomic Incompatibility Content. The extension of this axiom for the evaluation of ergonomic compatibility requirements was the theoretical framework of this research. An incremental methodology of four stages was used to design and develop the software that enables to compare AMT alternatives by the evaluation of Ergonomic Compatibility Attributes. Show more

Keywords: advanced manufacturing technology, ergonomic compatibility evaluation, ergonomic incompatibility content, software development, fuzzy axiomatic design approach

DOI: 10.3233/WOR-2012-0386-1782

Citation: Work, vol. 41, no. Supplement 1, pp. 1782-1789, 2012

Authors: Arellano, Juan Luis Hernández | Mejía, Gabriel Ibarra | Pérez, J Nieves Serratos | Alcaraz, Jorge Luis Garcí | Brunette, María Julia

Article Type: Research Article

Abstract: Operators of machinery classified as Advanced Manufacturing Technology (AMT) are exposed to high levels of workload and fatigue. However, only few studies have been conducted on this topic in Hispanic-American countries workers. Several instruments be used to assess workload and fatigue; however, only few of them have been adapted to Spanish language. This paper reports on the development and validity testing of a survey instrument in Spanish, aiming to subjectively assess workload and fatigue among AMT operators in Mexico. Method: After an exhaustive literature review in search of already available measurement instruments, they were adapted for content and later translated …into Spanish; a pilot test was conducted to evaluate validity and reliability; afterwards appropriate modifications were made to the testing instruments. Final version of the instrument was applied to a group of 121 operators of CNC lathes. Reliability was analyzed using KMO and Cronbach alpha indices. Results: For the assessment of workload, both NASA-TLX and ISTAS 21 methods were incorporated to the survey instrument. As for fatigue assessment tools, these were SOFI-S, FAS and OFER questionnaires. Results show KMO value and Cronbach alpha above 0.6.Conclusions. The survey instrument as designed, allows the collection of reliable and valid data regarding workload and fatigue among AMT operators in Mexico. Show more

Keywords: fatigue, workload, assessment, reliability, AMT

DOI: 10.3233/WOR-2012-0387-1790

Citation: Work, vol. 41, no. Supplement 1, pp. 1790-1796, 2012

Authors: Ozok, Ahmet F.

Article Type: Research Article

Abstract: American Medical Institute reports that each year, because of the medical error, minimum fifty thousand people are dead. For a safety and quality medical system, it is important that information systems are used in health care systems. Health information applications help us to reduce the human error and to support patient care systems. Recently, it is reported that medical information systems applications have also some negative effect on all medical integral elements. The cost of health care information systems is about 4.6% of the total cost. In this paper, it is tried a risk determination model according to principles of …fuzzy logic. The improvement of health care systems has become a very popular topic in Turkey recent years. Using necessary information system; it became possible to care patients in a safer way. However, using the necessary HIS tools to manage of administrative and clinical processes at hospitals became more important than before. For example; clinical work flows and communication among pharmacists, nurses and physicians are still not enough investigated. We use fuzzy modeling as a research strategy and developed sum fuzzy membership functions to minimize human error. In application in Turkey the results are significantly related with each other. Besides, the sign differences in health care information systems strongly effects of risk magnitude. The obtained results are discussed and some comments are added. Show more

Keywords: Health care system, fuzzy modeling, health care information system, improvement of health care systems, system design

DOI: 10.3233/WOR-2012-0646-1797

Citation: Work, vol. 41, no. Supplement 1, pp. 1797-1800, 2012

Authors: Gurses, Ayse P. | Martinez, Elizabeth A. | Bauer, Laura | Kim, George | Lubomski, Lisa H. | Marsteller, Jill A. | Pennathur, Priyadarshini R. | Goeschel, Chris | Pronovost, Peter J. | Thompson, David

Article Type: Research Article

Abstract: Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a …total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians’ in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders. Show more

Keywords: Safety, Cardiac surgery, Medical error, Human factors

DOI: 10.3233/WOR-2012-0388-1801

Citation: Work, vol. 41, no. Supplement 1, pp. 1801-1804, 2012

Authors: Vassilakopoulou, Polyxeni | Tsagkas, Vassilis | Marmaras, Nicolas

Article Type: Research Article

Abstract: This paper investigates workarounds occurring while pharmacists use an electronic prescription (ePrescription) application. ePrescription enables physicians to send prescriptions electronically to pharmacies and was recently introduced in Greece as a solution for controlling the ever-increasing medication costs and improving patient safety. The research was carried out in two phases: (i) review of the relevant documentation, (ii) fieldwork (field observations and semi-structured interviews with the pharmacists) in three pharmacies. The workarounds identified fall into five categories and namely: (a) bypass of ePrescription application (i.e. ePrescription application is not used at all), (b) temporal nonconformity in the use of ePrescription application (i.e. …usage of the application, but not at the formally specified time), (c) catachresis of ePrescription application (i.e. usage of the application, but not according to the intended way), (d) ePrescription application substitution by another electronic application, and (e) delegation of ePrescription application usage to non-authorized users. The outcome of the research can be used for the improvement of multiple work system elements such as the tools, the procedures, the organisational arrangements and the policies. Show more

Keywords: workarounds, ePrescription, pharmacists, work analysis

DOI: 10.3233/WOR-2012-0389-1805

Citation: Work, vol. 41, no. Supplement 1, pp. 1805-1810, 2012

Authors: Righi, Angela Weber | Wachs, Priscila | Saurin, Tarcísio Abreu

Article Type: Research Article

Abstract: Complexity theory has been adopted by a number of studies as a benchmark to investigate the performance of socio-technical systems, especially those that are characterized by relevant cognitive work. However, there is little guidance on how to assess, systematically, the extent to which a system is complex. The main objective of this study is to carry out a systematic analysis of a SAMU (Mobile Emergency Medical Service) Medical Regulation Center in Brazil, based on the core characteristics of complex systems presented by previous studies. The assessment was based on direct observations and nine interviews: three of them with regulator of …emergencies medical doctor, three with radio operators and three with telephone attendants. The results indicated that, to a great extent, the core characteristics of complexity are magnified) due to basic shortcomings in the design of the work system. Thus, some recommendations are put forward with a view to reducing unnecessary complexity that hinders the performance of the socio-technical system. Show more

Keywords: complex systems, emergency service, mobile emergency care

DOI: 10.3233/WOR-2012-0390-1811

Citation: Work, vol. 41, no. Supplement 1, pp. 1811-1817, 2012

Authors: Robertson, Michelle M. | Boiselle, Philip | Eisenberg, Ronald | Siegal, Dainel | Chang, Che-Hsu (Joe) | Dainoff, Marvin | Garabet, Angela | Garza, Jennifer Bruno | Dennerlein, Jack

Article Type: Research Article

Abstract: Radiologists are intensive computer users as they review and interpret radiological examinations using the Picture Archiving and Communication Systems (PACS). Since their computer tasks require the prolonged use of pointing devices, a high prevalence of Musculoskeletal Disorders (MSDs) is reported. The first phase of this study involved conducting a Cognitive Work Analysis in conjunction with a Participatory Ergonomics approach to perform a total work system analysis. We also conducted an ergonomic survey as well as collected computer use data, specifically for the mouse and keyboard. The goal of the study was to reduce the physical exposures for radiologists. This paper …presents Phase I results describing the analyses and redesign process of the radiologists tasks, training design, computer use, and selected survey results. Show more

Keywords: work systems analysis, participatory ergonomics, computer task exposure, musculoskeletal discomfort, training

DOI: 10.3233/WOR-2012-0391-1818

Citation: Work, vol. 41, no. Supplement 1, pp. 1818-1820, 2012

Authors: Pais, Fernando Lima | Azevedo, Paulo Roberto | Medeiros, Lícia Helena de Oliveira | de Freitas, Iraí Borges | Stamato, Cláudia

Article Type: Research Article

Abstract: This article is the result of an Ergonomic Diagnosis in a study for a Specialization Course in Ergonomics. The research is being done in a public hospital in the city of Rio de Janeiro, where the target system is the radiology sector. For diagnosis purposes, subjective techniques were used, such as an open-ended survey, Corlett questionnaire and techniques for evaluating ergonomic risk such as Owas and Rula. Systematic observation was emphasized using photos and films. Preliminary observations made to the radiographers found that these professionals suffer risks of physical and verbal harassment, as well as sexual harassment. Most of them …feel discriminated against in terms of race and accumulate activities demanding a lot of attention, as the medical diagnosis and subsequent procedures will depend on the outcome of this task. They accumulate tension due to the weight of responsibility, since there are cases where the patient has risk of death. Show more

Keywords: Ergonomic Diagnosis, radiology sector, ergonomic assessment

DOI: 10.3233/WOR-2012-0641-1821

Citation: Work, vol. 41, no. Supplement 1, pp. 1821-1827, 2012

Authors: Biquand, Sylvain | Zittel, Benoit

Article Type: Research Article

Abstract: Increased lifespan in western societies causes the increase of hospitalization in the old age, notably for patient showing forms of dementia including Altzheimer disease. These patients relate poorly to care givers and nurses, and cases of maltreatment have repeatedly been reported. To prevent abuse and increase patient’s quality of life, Gineste and Pelissier (2007) proposed a philosophy of care based on the Humanitude® concept. Acknowledging that being human is being vertical and related to other humans, the pillars of Humanitude® are gaze, touch, talk, and standing. These modes of relation are systematically developed in care giving techniques derived from the …concept. After several studies in geriatric hospitals, to assess psychosocial and ergonomic aspects of work, we present an analysis of the gap between the logic of human care and the logic of hospital organization, impacting employees work conditions and psychological welfare. Care giving is not only a “one to one” relation with the patient but needs to be integrated in the whole organization. Psychologists and ergonomists should be instrumental in defining the project and the organization linking human care giving towards the patients and better work conditions for healthcare employees. Show more

Keywords: work analysis, care, maltreatment, humanitude, burn-out

DOI: 10.3233/WOR-2012-0392-1828

Citation: Work, vol. 41, no. Supplement 1, pp. 1828-1831, 2012

Authors: Silvana, Salerno | Laura, Forcella | Ursula, Di Fabio | Irene, Figà Talamanca | Paolo, Boscolo

Article Type: Research Article

Abstract: Introduction. Patient’s aggressive behavior is one of the major problem in the psychiatric ward. Here we present the preliminary results of a psychiatric ward case-study, of a public hospital in the Chieti province, in order to plan ergonomic improvement. Method We applied the Method of Organizational Congruencies in the psychiatric ward in order to study the relationship between organized hospital work and nurses wellbeing in a 24 hour shifts. Results We observed 58 main phases in the three work shifts. The technical actions are mainly those of any hospital wards (shift briefing, preparing and administering drugs, recording data on clinical …charts, etc.). We found important differences mainly due to the nurses overcontrol activities on the patients behavior (preventing suicides or self destructive behavior), the occurrence of restraint procedure towards patients, the pollution due to patient’s cigarette smoke. Discussion The fear of patient’s self destructive behavior or other aggressive behaviour are the main cognitive and social aspects of this hospital ward. Nurses working in this psychiatric ward have to accept: locked doors, poor and polluted environment, restraint procedure with high risk of aggression and no availability of mental health care programs. A new interdisciplinary concept for ergonomics in psychiatry setting may represent a challenge for both nurses and patients and the community. Show more

Keywords: psychiatric ward, ergonomics, health care workers, nurses, aggressions

DOI: 10.3233/WOR-2012-0393-1832

Citation: Work, vol. 41, no. Supplement 1, pp. 1832-1835, 2012

Authors: Sacouche, D. A. | Morrone, L.C. | Silva-Júnior, J.S.

Article Type: Research Article

Abstract: Background: In health care services, the workers from laundry and linen services are exposed to various occupational hazards, including the ergonomic risk. Were decided to study the effect of ergonomic factors at work in the musculoskeletal system for employees in this sector. Methods: Cross-sectional study conducted in a mid-sized general hospital in Brazil. Site visit was conducted to apply recognition of occupational hazards and work activities flow. Medical evaluation of twenty-one workers was performed for designing the health status of them, focusing on orthopedic disorders. Results: Their activities are to distribute clothes in all units of hospital care in order …to organize and maintain supplies. The principal complaints were back pain (43%) and shoulder pain (24%). The ergonomic risk happens due to repeated movements of lumbar flexion in sealing, raising the arms above shoulder level in storage and transportation of loads on the distribution of clean clothes. Conclusions: The complaints by workers are consistent with the overloads identified in the evaluation of jobs. It is recommended to adjust anthropometrically the sealing workplace; the availability of stairs; the implantation of trolleys with four swivel wheels; short breaks during the workday; and to stretch the muscles before and during work. Show more

Keywords: ergonomics, musculoskeletal disease, hospital distribution system, occupational health

DOI: 10.3233/WOR-2012-0394-1836

Citation: Work, vol. 41, no. Supplement 1, pp. 1836-1840, 2012

Authors: Cabral, A. | Souza e silva, M. | Louzada, E. | Cesar, W.

Article Type: Research Article

Abstract: The purpose of this study is to describe the use of the Ergonomic Analysis of Work (EAW) in the process of rehabilitating workers, insured by the National Institute of Social Security (INSS) in Brazil, and to conduct a brief analysis of the instrument used by this body. Information obtained from EAW enabled the demand, the requirements of the activity and the skills needed to perform the tasks in the workplace to be determined, thus aiding the decision of the INSS as to rehabilitating the workers and their return to their jobs.

Keywords: professional rehabilitation, analysis of job, social security in Brazil

DOI: 10.3233/WOR-2012-0395-1841

Citation: Work, vol. 41, no. Supplement 1, pp. 1841-1848, 2012

Authors: Bandeira, Maria Goreth | Diniz, Raimundo Lopes | Sardinha, Ana Hélia

Article Type: Research Article

Abstract: The goal of this study was to comprehensively identify ergonomic constraints among nursing workers in two public hospitals in Brazil. We used a qualitative research design and conducted interviews, field observation and performed a subjective questionnaire with nurses of emergency care sectors. The Cronbach α technique was used to determine the internal consistency of the questionnaire. Based on this qualitative study, we identified some ergonomic constraints related to work environment, biomechanics/anthropometrics, work organization and work station (hospital direction).

Keywords: nurses, ergonomic constraints, emergency care, public hospital

DOI: 10.3233/WOR-2012-0396-1849

Citation: Work, vol. 41, no. Supplement 1, pp. 1849-1854, 2012

Authors: Sharan, Deepak | Ajeesh, PS

Article Type: Research Article

Abstract: This review targeted all research previously conducted on the topic of musculoskeletal disorders and injury among physiotherapists, with a particular focus on studies that had examined individual, physical and psychosocial risk factors and provided suggestions or recommendations to prevent such injuries. Scientific literature published in English languages was searched using electronic way. A total of 17 appropriate studies were located and examined, most of which had focused on the prevalence of musculoskeletal disorders/pan or any other injury. From the review, it was shown that major risk factors among the physiotherapist were manual therapy, repetitive movement, awkward and static posture, physical …load, lifting and transferring, treating large number of patients treating in a single day, working while injured, years of experience. The preventive measures that described in these literatures were awareness of reporting of injury, use of less manual therapy, proper exercise, formulation of new devices, intervention at the level of workplace, work schedule allocation, proper training, ongoing risk assessment and control. Show more

Keywords: “Work related musculoskeletal disorders”, “prevention mechanism”, “Ergonomics”

DOI: 10.3233/WOR-2012-0397-1855

Citation: Work, vol. 41, no. Supplement 1, pp. 1855-1859, 2012

Authors: Maciel, D.P. | Millen, R.A.M. | Xavier, C.A. | Morrone, L.C. | Silva-Júnior, J.S.

Article Type: Research Article

Abstract: Background: Experts in medical invasive evaluations, like colonoscopy, could be exposed to ergonomic risks during their work. Little attention has been given to these spectrum of occupational health. Its aimed to analyze possible clinical problems related to upper limb of physicians who perform those exams. Methods: Cross-sectional study in a health service in Sao Paulo, Brazil. For evaluation of the workplace of the colonoscopist physician were applied two tools: Couto´s check list and Sue Rodgers Method. The results direct the potential risk to upper limb injuries. Results: The procedure is done and the final report is issued. There are no …mandatory pauses during workday. The dominant hand holds the tube insertion with pincer movement during the exam, digital prehension being necessary at times. For this activity the employee has to use some strength. Couto´s check list indicates a significant biomechanical factor. Sue Rodgers´s Method states high ergonomic risk for dominant hand/wrist/fingers. Conclusion: The main risk for the development of health disorders are associated with the use of force and repetitive movements of hands. The adoption of regular breaks to recover most of the structures required is recommended. Show more

Keywords: colonoscopy, cumulative trauma disorders, occupational health, healthcare professional, ergonomics

DOI: 10.3233/WOR-2012-0398-1860

Citation: Work, vol. 41, no. Supplement 1, pp. 1860-1863, 2012

Authors: Long, Jennifer | Burgess-Limerick, Robin | Stapleton, Fiona

Article Type: Research Article

Abstract: Work-related musculoskeletal discomfort and injuries are reported by optometrists. The purpose of this paper is to describe the process used to investigate work-related discomfort in Australian optometrists. A multistage project was conducted which included questionnaires, interviews and onsite observations. Participants, with and without self-reported discomfort, included clinical optometrists, optometry students and clinical teachers. The various stages of the study developed over the course of the project, primarily in response to results collected at various stages. A multistage approach proved valuable for confirming results and testing hypotheses, and for investigating different groups of workers (clinicians, teachers and students). General guidelines to …reduce the risk of work-related discomfort in optometrists can be developed from this project. Specific recommendations and teaching curricula have been identified in this project as areas of future research and development. Show more

Keywords: education, guidelines, interview, observation, questionnaire

DOI: 10.3233/WOR-2012-0399-1864

Citation: Work, vol. 41, no. Supplement 1, pp. 1864-1868, 2012

Authors: Lemo, A | Silva, A G | Tucherman, M | Talerman, C | Guastelli, R L | e Borba, C L

Article Type: Research Article

Abstract: The hospitals mostly have a high level of complexity, diversity of services and, consequently, occupational risks. The tasks of mobilization and manual repositioning of patients may require professional of the physical demands due to the weight or excessive patient dependency, attitudes arising from inadequate to lean on a bed or work in a restricted area, sudden weight change that can occur if a patient loses balance or strength to change the position or while moving. These, among many other factors can cause or aggravate musculoskeletal problems in health care workers. These diseases translate into frequent musculoskeletal complaints, high rates of …absenteeism, licenses and problems of prolonged labor, creating a vicious cycle that compromises patient safety and performance of institutions. The literature has suggested the administration of courses on handling and transportation of patients as one of the most important strategies to reduce the incidence of problems in the spine between the worker’s healths. An exercise program emphasizing global distension and strength, mainly the posterior chain muscles (dorsal region), held twice a week, combined with an approach to ergonomics can reduce musculoskeletal symptoms and absenteeism in nursing. Show more

Keywords: ergonomics, musculoskeletal disorders, nursing, hospital

DOI: 10.3233/WOR-2012-0400-1869

Citation: Work, vol. 41, no. Supplement 1, pp. 1869-1872, 2012

Authors: Yeung, Simon S.

Article Type: Research Article

Abstract: This study aims to preliminary explore the work related and individual factors that contributed to the occurrence of low back pain (LBP) that affected work activities of Personal Care Workers (PCWs). A cross-sectional study was conducted to 36 PCWs in an old age home of Hong Kong. The study is divided into three parts: 1) a questionnaire to document the workload exposure factors and the musculoskeletal symptoms survey of the PCWs, 2) work posture evaluation; and 3) an evaluation of the physical fitness and lifting capacity of the PCWs. Univariate analyses were used to explore the risk factors associated with …LBP that affected work activities. The results indicated that individual physical profile and lifting capacities did not contribute to occurrence of low back pain at work. For the work demand factors, the perceived physical demands in lifting and lowering heavy objects, awkward sustain neck and back postures, loading on the back, and perceived effort of cleaning task contributed to the occurrence of LBP. For the physical environment factors, thermal stress and improper ventilation were associated with the occurrence of LBP cases. For the individual factor, LBP cases were associated with workers’ self perceived muscular effort, and perceived risk of mental illness in response to work requirements. Show more

Keywords: Low back pain, risk factors, personal care workers

DOI: 10.3233/WOR-2012-0401-1873

Citation: Work, vol. 41, no. Supplement 1, pp. 1873-1883, 2012

Authors: McCrory, Bernadette | Lowndes, Bethany R. | Wirth, Laura M. | de Laveaga, Adam E. | LaGrange, Chad A. | Hallbeck, M. Susan

Article Type: Research Article

Abstract: Although laparoendoscopic single-site surgery (LESS) is feasible among expert laparoscopic surgeons, it poses many technical challenges not seen in conventional laparoscopy (CL). Recent technological advancements in single-incision instrumentation have created more interest and widespread usage of LESS. However, neither LESS nor its novel instrumentation have been thoroughly studied or evaluated using human factors and ergonomics techniques. Consequently, the aim of this study was to compare the physical performance of LESS to CL using a standardized task. Wrist and elbow angular movements, range of motion and physical discomfort were assessed for 24 novice participants. There were no significant differences for physical …comfort/discomfort ratings or elbow and wrist flexion/extension range of motion between CL and LESS. However, wrist radial/ulnar range of motion was significantly greater in LESS compared to CL (p < 0.05). Additionally, wrist radial/ ulnar range of motion was significantly greater using the SILS Port compared to the GelPOINT (p < 0.05). Although further investigation is needed, LESS resulted in greater wrist deviation and range of motion due to the close proximity of the instruments, restrictive nature of the single-port devices, and the need to achieve adequate instrument triangulation and visualization. Show more

Keywords: single-incision, laparoscopy, goniometry, human factors, simulation

DOI: 10.3233/WOR-2012-0402-1884

Citation: Work, vol. 41, no. Supplement 1, pp. 1884-1890, 2012

Authors: Sharan, Deepak | Ajeesh, PS | Rameshkumar, R | Manjula, M

Article Type: Research Article

Abstract: The patients of cerebral palsy need assistance for their self activities which expose the caregivers to different risk factors of musculoskeletal disorders. But there is a scarcity of studies revealing the prevalence and the risk factors present among the caregivers of the cerebral palsy children. This lead to formulate a study to identify prevalence and risk factors among the caregivers of cerebral palsy children. Result revealed that most of the caregivers among both the groups were female (63.4% and 69.3%). The common age group of the children who underwent multilevel surgery was at the age group of 6 – 10 …years. It has been observed that among the study group 56.5% were totally cooperative children. The Caregiver Strain Index value showed there is no significant difference among both the groups. Regional body pain of shoulder, elbow, upper back, lower back and ankle revealed a higher prevalence among the study group. Clinical diagnosis revealed prevalence of MPS, FMS and TOS among the study group were 27.6%, 24.5% and 23.0% respectively. Study further revealed that cooperativeness of the child was significantly associated with lower back pain, MPS, FMS and TOS among the study group. Show more

Keywords: “Modified Care givers Strain Index”, “visual analog scale”, “Lifting and carrying”

DOI: 10.3233/WOR-2012-0403-1891

Citation: Work, vol. 41, no. Supplement 1, pp. 1891-1895, 2012

Authors: Kenny, Vélez V. Martha | Verónica, Nolivos | Fabricio, Alegría

Article Type: Research Article

Abstract: The pressure distribution on the plantar surface may reveal information not only about the feet structure, also it may bring out information about the entire body posture not only on health but also pathologic conditions. The application in ergonomics and ocupational health gives acces to the postural correction that on a long term may provoke professional injuries giving presition and security. This study is on 132 workers of Universidad de las Américas.

Keywords: baropodometric, ergonomics, pressure plantar, body posture, preventive injuries

DOI: 10.3233/WOR-2012-0404-1896

Citation: Work, vol. 41, no. Supplement 1, pp. 1896-1899, 2012

Authors: Kenny, Vélez V. Martha | Verónica, Nolivos | Fabricio, Alegría

Article Type: Research Article

Abstract: The ergonomic risks constitute a vital aspect of study and prevention for the worker’s health, especially for people with different capacities. Very job has and implies certain type of risk for the worker’s health, depending on the conditions it is done with the use of tools or without them. Aplicated techniques: posturogram, baropodometry, Schober test, biocinemátic chain test, Fukuda test, propioceptiva plataform in personnel with special capabilities

Keywords: Ergonomic risk, posturogram, special capabilities, propioceptiva platform, preventive injuries

DOI: 10.3233/WOR-2012-0405-1900

Citation: Work, vol. 41, no. Supplement 1, pp. 1900-1903, 2012

Authors: Samaras, Elizabeth A. | Real, Sara D. | Curtis, Amber M. | Meunier, Tessa S.

Article Type: Research Article

Abstract: Proper identification of all stakeholders and the comprehensive assessment of their evolving and often conflicting Needs, Wants, and Desires (NWDs) is a fundamental principle of human factors science and human-centered systems engineering; it is not yet a consistent element in development and deployment of new health information technologies (HIT). As the single largest group of healthcare professionals, nurses are critical stakeholders for these new technologies. Careful analysis can reveal nurse stakeholder dissonance (NSD) when integrating new technologies into the healthcare environment. Stakeholder dissonance is a term that describes the conflict between the NWDs of different stakeholders which, if left unresolved, …can result in dissatisfaction, workarounds, errors, and threats to patient safety. Three case studies drawn from the authors’ experience in a variety of acute-care settings where new HITs have been recently deployed are examined to illustrate the concept of NSD. Conflicting NWDs, other stakeholders, and possible root causes of the NSD are analyzed and mapped to threats to patient safety. Lessons learned, practical guidance for anticipating, identifying, and mitigating NSD, future research and implications for HFE and nursing practice are discussed. Show more

Keywords: ‘case studies’, CPOE, EMR, ‘human factors’

DOI: 10.3233/WOR-2012-0406-1904

Citation: Work, vol. 41, no. Supplement 1, pp. 1904-1910, 2012

Authors: Smith, Elizabeth (Lizzy) M

Article Type: Research Article

Abstract: The effectiveness of occupational health and safety management systems (OHSMS) can be understood through analysis of surveys such as the experiences of exposure to occupational hazards by Australian nursing occupations. How effectively OHSMS are implemented in the Australian health industry is unclear as few studies describe current hazard exposure patterns or the impact of OHSMS in the Australian health industry. This paper concludes from the analysis of an Exposure Survey of Australian nursing occupations that nursing occupations perceive themselves to be “at risk” of injury and/or management of OHS risk in work duties is affected by the patterns of hazard …exposure, occupation group as well as employee attributes, perceptions, patterns and situations of work. The results highlight the top-rated hazards and imply that the perceptions of hazards in the workplace are different to actual risk experience (e.g. injury patterns). There is an unacceptable level of exposure to diverse hazards in Australian nursing occupations workplaces in regard to regulatory and performance obligations. Stronger strategies to achieve more effective risk treatment, integrate with hospital accreditation and quality programs are discussed to benefit system performance and the welfare of those in nursing occupations. Show more

Keywords: hazard, exposure nursing, safety, systems

DOI: 10.3233/WOR-2012-0407-1911

Citation: Work, vol. 41, no. Supplement 1, pp. 1911-1919, 2012

Authors: Battevi, Natale | Menoni, Olga

Article Type: Research Article

Abstract: International standards highlight the steps required by risk assessment and involving first hazard identification, then risk evaluation and finally, if necessary, risk assessment. To check approach appropriateness to “risk evaluation” from manual patient handling through MAPO, a cross study was carried out in view of checking relationship between this new risk assessment model and occurrence of acute low back pain. After proper training the MAPO screening method was assessed in 31 wards, 411 exposed subjects of geriatric hospitals. At the same time health data were collected on occurrence of low back pain episodes during the last year both in the …exposed subjects’ group and the external reference group (n°237). Risk and clinical assessment data were tutored and checked by EPM research unit. The logistic analysis was used as a method to evaluate the relationship between risk index and acute low back pain. Investigating relationship between acute low back pain episodes and levels of MAPO screening index, carried out only with the people exposed who claimed to work for at least 30 hours per week (n = 178), showed definitely positive trends. The study results indicate that MAPO screening may represent a useful tool to estimate the risk from manual handling patients. Show more

Keywords: Lifting patients, low back pain, risk assessment, nurses

DOI: 10.3233/WOR-2012-0408-1920

Citation: Work, vol. 41, no. Supplement 1, pp. 1920-1927, 2012

Authors: Luz, Taciana Ramos | de Oliveira Echternacht, Eliza Helena

Article Type: Research Article

Abstract: This study aims to analyze the factors that justify the low use of a mechanical transfer in the context of a long-term institution. It is a device intended for internal transportation of individuals who have mobility problems. The analysis involves researchers from the fields of health and engineering in order to generate design criteria that consider the needs of caregivers and patients of this institution. To understand the reality of this site and their specificities, was used Ergonomic Work Analysis.

Keywords: mechanical transfer, elderly, ergonomics, sling, transfer

DOI: 10.3233/WOR-2012-0409-1928

Citation: Work, vol. 41, no. Supplement 1, pp. 1928-1932, 2012

Authors: Ribeiro, Sânzia Bezerra | Cárdia, Maria Claudia Gatto | Almeida, Lais Cristina

Article Type: Research Article

Abstract: The objective present study was to investigate the presence of low back pain in caregivers of a nursing home, related with the labored activities executed by these workers. 16 subjects were investigated, 15 female and one male, with 40,8 age average all being caregivers as their profession. It consisted of three phases, where the first concerns the analysis of the collective work, assessed in a perspective of caregivers, Second, a postural assessment to verify the retractions in such workers and the third stage was used Diagram of Corllet to identify the presence of signs and symptoms in caregivers. The study …demonstrated that organizational and biomechanical factors are responsible for the high level of physical fatigue and presence of pain in 93,75% of the caregivers in some region of the body. 50% referred pain in the lumbar region. The results of the postural evaluation confirmed that the caregivers had alterations in the postural alignment, presenting retractions of the anterior and posterior chain. The suggestions are to minimize the risk factors of this productive process and the symptoms and signals presented from these workers by adoption ergonomic measures and the realization of a physical program with stretching and muscular strengthening of the muscles of thee anterior and posterior body chain based on the method of Reorganization Postural Sensoperceptive . Show more

Keywords: low back pain, caregivers, enderly, overload work

DOI: 10.3233/WOR-2012-0410-1933

Citation: Work, vol. 41, no. Supplement 1, pp. 1933-1939, 2012

Authors: Hermanson, James E. | Choi, Sang D.

Article Type: Research Article

Abstract: Due to the cost and time benefits associated with patients and physicians, outpatient surgeries continue to become more and more popular over time. With the increase in the number of office-based surgical procedures, the prevalence of work-related musculoskeletal disorders (WMSDs) associated with office-based surgeries has been reported. The purpose of this pilot study is to ergonomically evaluate the risk of work-related musculoskeletal disorders of physicians/surgeons performing office-based surgery (OBS). Ergonomic assessment tools included Questionnaire, the BodyMap and the Rapid Upper Limb Assessment for measuring potential ergonomic concerns. The findings have shown that the ergonomic issues of greatest concerns were the …discomforts in the neck, shoulders, arms/wrists, and back. Some additional comments were provided by the participants regarding the duration of discomfort or clarification on the frequency of their body discomfort. This study suggests that there is a considerable risk of musculoskeletal injuries of physicians/surgeons performing the OBS tasks. By properly using the ergonomic assessment techniques, valuable information on ergonomic OBS workplace design and selection could assist in the early interventions of WMSD prevention. Show more

Keywords: ergonomic assessment, body discomfort, work posture, musculoskeletal disorders, healthcare

DOI: 10.3233/WOR-2012-0411-1940

Citation: Work, vol. 41, no. Supplement 1, pp. 1940-1943, 2012

Authors: Yu, Denny | Sackllah, Michael | Woolley, Charles | Kasten, Steven | Armstrong, Thomas

Article Type: Research Article

Abstract: The purpose of this paper is to present a quantitative posture analysis of microsurgery tasks performed with different visualization methods. Microsurgery is traditionally performed using a binocular microscope; however surgeons are constrained by the optical eyepieces and are forced to assume joint angles that deviate away from neutral postures. This may be especially problematic for the neck and can increase surgeon discomfort and fatigue. Alternative visualization methods may improve surgeon posture by eliminating the constraints imposed by the microscope. This study examines both 2D and 3D heads-up displays as possible alternatives. Six subjects performed microsurgical tasks with each visualization methods …for four hours. Quantitative posture analysis was done using Maxtraq software that tracks reflective markers on the subjects. The initial analysis of neck, upper arm, and elbow angles found significant differences between each display. A biomechanical analysis found that the differences in angles can result in loads on the neck joint that are twice as high in the microscope than the headsup displays. Although the alternative displays can result in better postures, improvements the display technology is needed to improve microsurgical task performance. Show more

Keywords: microscope, heads-up display, posture analysis, surgery

DOI: 10.3233/WOR-2012-0412-1944

Citation: Work, vol. 41, no. Supplement 1, pp. 1944-1947, 2012

Authors: Samaras, George M.

Article Type: Research Article

Abstract: Healthcare information technology (HIT) is being offered as a transformer of modern healthcare delivery systems. Some believe that it has the potential to improve patient safety, increase the effectiveness of healthcare delivery, and generate significant cost savings. In other industrial sectors, information technology has dramatically influenced quality and profitability – sometimes for the better and sometimes not. Quality improvement efforts in healthcare delivery have not yet produced the dramatic results obtained in other industrial sectors. This may be that previously successful quality improvement experts do not possess the requisite domain knowledge (clinical experience and expertise). It also appears related to …a continuing misconception regarding the origins and meaning of work errors in healthcare delivery. The focus here is on system use errors rather than individual user errors. System use errors originate in both the development and the deployment of technology. Not recognizing stakeholders and their conflicting needs, wants, and desires (NWDs) may lead to stakeholder dissonance. Mistakes translating stakeholder NWDs into development or deployment requirements may lead to latent errors. Mistakes translating requirements into specifications may lead to drift errors. At the sharp end, workers encounter system use errors or, recognizing the risk, expend extensive and unanticipated resources to avoid them. Show more

Keywords: human factors, healthcare, technology, quality, improvement

DOI: 10.3233/WOR-2012-0413-1948

Citation: Work, vol. 41, no. Supplement 1, pp. 1948-1955, 2012

Authors: Nascimento, Adelaide | Falzon, Pierre

Article Type: Research Article

Abstract: The purpose of this article is to understand the way in which medical physicists take into account treatment effectiveness and safety when selecting a treatment plan, with respect to the medical prescription and the technical, human and organizational resources available. Data-gathering was based on the allo-confrontation method: 14 medical physicists from five different treatment centers commented on real treatment plans that had been drawn up by their colleagues. Results show that medical physicists have two means at their disposal to control treatment effectiveness and safety: risk avoidance and risk reduction. Risk avoidance is achieved when conceiving the solution. Risk reduction …occurs after the design of the plan and consists in accompanying and assisting the radiographers at the work station where the treatment is carried out. Show more

Keywords: safety, effectiveness, quality, radiotherapy

DOI: 10.3233/WOR-2012-0414-1956

Citation: Work, vol. 41, no. Supplement 1, pp. 1956-1960, 2012

Authors: Smith, Thomas J.

Article Type: Research Article

Abstract: This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children’s hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of …selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. Conclusions: (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues. Show more

Keywords: intensive care, private room design, occupancy quality

DOI: 10.3233/WOR-2012-0415-1961

Citation: Work, vol. 41, no. Supplement 1, pp. 1961-1968, 2012

Authors: Van der Molen, Henk F. | Zwinderman, Koos AH | Sluiter, Judith K. | Frings-Dresen, Monique H.W.

Article Type: Research Article

Abstract: Needle stick injuries (NSIs) are frequently reported as occupational injuries among health care workers. The health effects of a NSI can be significant when blood-to-blood contact occurs from patient to health care worker. The objective of this study was to evaluate whether the number of NSIs decreased among health care workers at risk in one Dutch academic hospital after introduction of injection needles with safety devices in combination with an interactive workshop. In a cluster threearmed randomized controlled trial, 23 hospital divisions (n=796 health care workers) were randomly assigned to a group that was subjected to the use of a …‘safety device plus workshop’, to a group that was subjected to a ‘workshop only’ or to a control group with no intervention. The combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention. For practice, the use of relatively simple protective needle safety devices and interactive communication are effective measures for reducing NSI’s. Show more

Keywords: needle stick injuries, prevention, health care

DOI: 10.3233/WOR-2012-0416-1969

Citation: Work, vol. 41, no. Supplement 1, pp. 1969-1971, 2012

Authors: Cuvelier, L. | Falzon, P. | Granry, J.C. | Moll, M.C.

Article Type: Research Article

Abstract: This study aims to describe how anesthesia teams handle unforeseen events that may affect the patients’ health. More precisely, it investigates the mechanisms of decisions made by anesthesia teams to manage unthought-of situations, i.e. situations that have not been foreseen as “possible” ones before their occurrence. An empirical study, based on the analysis of simulated situations, was conducted in a pediatric anesthesia service of a university hospital in France. The results highlighted three ways of managing unthought-of situations (determined management, cautious management and overwhelmed management). They support the hypothesis of a collective cognitive trade-off, whereby teams would behave as virtual …operators, with their own collective trade-off between "understanding" and "doing". The discussion of the results questions the assessment criteria, the safety perspectives we adopt and the possible ways to improve the management of unforeseen situations. Show more

Keywords: patient safety, adaptive safety, simulation, team work, unexpectedness

DOI: 10.3233/WOR-2012-0417-1972

Citation: Work, vol. 41, no. Supplement 1, pp. 1972-1979, 2012

Authors: Moody, Louise | Woodcock, Andree | Heelis, Mike | Chichi, Cynthia | Fielden, Simon | Stefanov, Dimitar

Article Type: Research Article

Abstract: Wheelchair users experience many situations that affect the stability and associated performance of their wheelchair. Stability is affected by user characteristics and abilities, environmental features and conditions, and wheelchair modification and accessories. Wheelchair prescribers need effective tools and methods to provide quantitative evaluation and prediction of the behavior of the user-wheelchair system in a variety of static and dynamic situations. Such information is very important to guide efficient management of associated risks and adjust chairs accordingly. This project involves a user-centered approach for design and evaluation of a load cell based wheelchair stability assessment system (Wheel-SAS). Here, the current methods …for assessing stability are described, and their shortcomings explained. The user-centered design approach being applied to the development of the associated Wheel-SAS hardware and software is described. Future work including semi-structured interviews and an online survey with wheelchair prescribers and associated healthcare professionals for deriving user requirements and a design specification for a load cell system for measuring dynamic wheelchair stability are detailed. Show more

Keywords: wheelchair stability assessment, wheelchair prescription, Wheel-SAS

DOI: 10.3233/WOR-2012-0418-1980

Citation: Work, vol. 41, no. Supplement 1, pp. 1980-1984, 2012

Authors: Willemen, Tim | Van Deun, Dorien | Verhaert, Vincent | Pirrera, Sandra | Exadaktylos, Vasileios | Verbraecken, Johan | Haex, Bart | Sloten, Jos Vander

Article Type: Research Article

Abstract: Ergonomic sleep studies benefit from long-term monitoring in the home environment to cope with daily variations and habituation effects. Polysomnography allows to asses sleep accurately, but is costly, time-consuming and possibly disturbing for the sleeper. Actigraphy is cheap and user friendly, but for many studies lacks accuracy and detailed information. This proof-of-concept study investigates Least-Squares Support Vector Machines as a tool for automatic sleep stage classification (Wake-N1-Rem to N2-N3 separation), using automatic trainingset-specific filtered features as derived from three easy to register signals, namely heart rate, breathing rate and movement. The algorithms are trained and validated using 20 nights out …of a 600 night database from over 100 different healthy persons. Different training and test set strategies were analyzed leading to different results. The more person-specific the training nights to the test nights, the better the classification accuracy as validated against the hypnograms scored by experts from the full polysomnograms. In the limit of complete person-specific training, the accuracy of the algorithm on the test set reached 94%. This means that this algorithm could serve its use in long-term monitoring sleep studies in the home environment, especially when prior person-specific polysomnographic training is performed. Show more

Keywords: LS-SVM, actigraphy, polysomnography

DOI: 10.3233/WOR-2012-0419-1985

Citation: Work, vol. 41, no. Supplement 1, pp. 1985-1989, 2012