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Resources of Strength: An Exnovation of Hidden Competences to Preserve Patient Safety
Published in Emma Rowley, Justin Waring, A Socio-cultural Perspective on Patient Safety, 2017
In the following I will explore different ways to study resources of safety. The neonatal intensive care unit (NICU) can serve as a context for presenting examples of studies on causes of safety. This ward is specialized in the care and treatment of newborns. Very young babies end up in a NICU because their lives are seriously at risk on account of their prematurity, complications at birth, congenital diseases or potentially lethal infections. Needless to say, this vulnerable patient population calls for a high level of patient safety and special care. The interventions necessitate a dynamic, intricate and ongoing fine-tuning of actions and reactions among the individual clinicians, as well as between clinicians and the technology they use. Since this chapter aims to discuss the relevancy of a particular analytical focus – one that includes the unproblematic, the ordinary, the usual, the regular – the empirical data reported have to be considered as illustrations, rather than serving as hard evidence of a fine-grained analysis of hidden competences as such.
Channelling Erratic Flows of Action: Life in the Neonatal Intensive Care Unit
Published in Christine Owen, Pascal Béguin, Ger Wackers, Risky Work Environments, 2017
The neonatal intensive care unit (NICU), in particular, constitutes a domain where the challenges and opportunities of new medical knowledge and technology converge. As an outpost of today’s health care system where the pioneering sprit of medicine reigns supreme, it serves as an exemplary case for studying some of the concrete vulnerabilities in the health system triggered by this permanent dynamic of change. The NICU specializes in the care and treatment of newborns. Very young babies end up in the NICU because their lives are seriously at risk on account of their prematurity, complications at birth, congenital diseases, or potentially lethal infections. This practice is determined by the ongoing flow of activities associated with highly specialized care provision, the admission of new patients (including their parents), as well as by the fluctuations in the conditions of the patients. In this regard, the NICU can be considered a ‘High-3 work environment’. See Chapter 8 for a detailed description of the nature of High-3 practices.
Evaluating Timebands as a Tool for Structuring the Design of Socio-Technical Systems
Published in Philip D. Bust, Contemporary Ergonomics 2007, 2018
Gordon Baxter, Alan Burns, Kenneth Tan
In the neonatal intensive care unit (NICU), staff routinely use technology in treating premature babies (by delivering drugs and food, assisting breathing, monitoring the baby’s vital signs and so on). One of the problems often faced by these babies is respiratory distress syndrome. This is treated by a combination of medication and mechanical ventilation. The aim is to ensure that the baby’s blood gases remain within predefined limits whilst it recovers from the self-regulating disease. The blood gases are continuously monitored, and if they go out of range, adjustments are made to the settings on the mechanical ventilator that helps the baby to breathe. It is crucial that these adjustments are made in a safe and timely manner.
Thermogram classification using deep siamese network for neonatal disease detection with limited data
Published in Quantitative InfraRed Thermography Journal, 2022
A limited data set has been used in almost all previous studies to diagnose newborn diseases early. This is because collecting data in the neonatal intensive care unit is complex for the reasons we mentioned earlier. In the studies, artificial neural networks (ANNs) and convolutional neural networks (CNNs) were preferred and binary classification (healthy – unhealthy or healthy – necrotising enterocolitis (NEC) patient) was performed. Beyond the fact that the patient examined is healthy or unhealthy, one of the following two points is needed to determine in advance what diseases the patient has; 1) Too much data from each disease class or 2) an algorithm to give better results in unbalanced/limited data sets. Some previous work has found promising results in healthy – unhealthy classification using ANN or CNN architectures [32,33]. For example, in the study in which babies with NEC were detected, 90% +/˗12% specificity and 78% +/˗18% sensitivity values were achieved with over 90% accuracy using decision trees with regression analysis [35]. Our study is unique because a proposed technique will not be affected by the number of data and the data imbalance between the classes. Thus, the classifier, which can distinguish between seven classes with inadequate and unbalanced data, was proposed and diseases were classified.
Plasticizers in the neonatal intensive care unit: A review on exposure sources and health hazards
Published in Critical Reviews in Environmental Science and Technology, 2022
Lucas Panneel, Govindan Malarvannan, Philippe G. Jorens, Adrian Covaci, Antonius Mulder
In recent decades, survival rates in the Neonatal Intensive Care Unit (NICU) have improved significantly. Nevertheless, surviving neonates are still challenged with long-term consequences, especially respiratory (Jensen & Schmidt, 2014; Jobe & Bancalari, 2001) and neurodevelopmental impairments (Fawke, 2007), which can be partially explained by early complications of prematurity. Neonatal intensive care relies on several indwelling plastic medical devices with a crucial and fundamental role in respiratory support, IV catheterization, and nutrition. Intensive and continuous exposure to these invasive medical devices, while being in a critical developmental period (Raybaud et al., 2013; Woods, 2016) with immature renal function (Gubhaju et al., 2014) and low body weight, makes premature neonates more susceptible to DEHP and APs potential toxicity (Lai & Bearer, 2008). Appropriately, the SCENIHR claimed these premature neonates to be at risk of exposure to plasticizers (Testai et al., 2016). It is of the utmost importance that adequate information is gathered on the safety of medical devices employed in the NICU to fill the remaining knowledge gaps on exposure and health effects of plasticizers in the NICU. This review provides a comprehensive overview of DEHP and APs on the sources of exposure in the NICU, the evolution and total exposure in the NICU and the resultant health risk in (premature) infants and children (Figure 2).
Mathematical model based on the radiosity method for estimating the efficiency of in-duct UVGI systems
Published in Science and Technology for the Built Environment, 2022
Emilio-José Sarabia-Escriva, Víctor-Manuel Soto-Francés, José-Manuel Pinazo-Ojer
The effects of UV on organisms were first described in 1877 by (Downes and Blunt 1877), but it was not until 1937 when the first application appeared. This application consisted of using ultraviolet germicidal irradiation (UVGI) system to control the spread of the measles virus (Wells, Wells, and Wilder 1942). Another strategy based on using the UVGI in the ventilation system was described by (Ryan et al. 2011). They observed a significant reduction in cases associated with pneumonia in a neonatal intensive care unit. Nowadays, UVGI systems are used in water, air and surfaces disinfection. UVGI air disinfection has different modes of use: irradiation of the upper-room air (Kanaan et al. 2015); in these cases it is vital to carry out a study to ensure the safety (Hou, Pantelic, and Aviv 2021) and the effectiveness (Noakes, Beggs, and Sleigh 2004) of the system and the quality of the indoor air (Kanaan 2019); irradiation of the entire room when there is no occupancy (Krishnamoorthy and Tande 2016); irradiation of the air through ducts (Luo and Zhong 2021) and irradiation over surfaces. (Reed 2010) extensively analyses the different applications of this technology in air cleaning. Some studies analyze the combination of different disinfection strategies. (Centers for Disease Control and Prevention of U.S. Department of Health and Human Services 2003) recommend using UVGI systems as a complement, not as a substitute, for filters in healthcare facilities.