Nursing resource implications of the unoccupied bed

Objective: To explore the specific factors that impact on nursing resources in relation to the ‘unoccupied bed’. Design: Descriptive observational Setting: Multiple wards in single site, tertiary referral hospital Main outcome measure: Identification and classification of tasks related to the unoccupied bed. Results: Our study identified three main areas of nursing work, which centre on the ‘unoccupied bed’: 1) bed preparation for admission; 2) temporary transfer; 3) bed preparation post patient discharge. Conclusion: The unoccupied bed is not resource neutral and may involve considerable nursing time. The time associated with each of the reasons for the bed being unoccupied remains to be quantified.

The provision of patient personal hygiene in the intensive care unit : a descriptive exploratory study of bed-bathing practice

Background/objectives The provision of the patient bed-bath is a fundamental nursing care activity yet few quantitative data and no qualitative data are available on registered nurses’ (RNs) clinical practice in this domain in the intensive care unit (ICU). The aim of this study was to describe ICU RNs current practice with respect to the timing, frequency and duration of the patient bed-bath and the cleansing and emollient agents used. Methods The study utilised a two-phase sequential explanatory mixed method design. Phase one used a questionnaire to survey RNs and phase two employed semi-structured focus group (FG) interviews with RNs. Data was collected over 28 days across four Australian metropolitan ICUs. Ethical approval was granted from the relevant hospital and university human research ethics committees. RNs were asked to complete a questionnaire following each episode of care (i.e. bed-bath) and then to attend one of three FG interviews: RNs with less than 2 years ICU experience; RNs with 2–5 years ICU experience; and RNs with greater than 5 years ICU experience. Results During the 28-day study period the four ICUs had 77.25 beds open. In phase one a total of 539 questionnaires were returned, representing 30.5% of episodes of patient bed-baths (based on 1767 bed occupancy and one bed-bath per patient per day). In 349 bed-bath episodes 54.7% patients were mechanically ventilated. The bed-bath was given between 02.00 and 06.00 h in 161 episodes (30%), took 15–30 min to complete (n = 195, 36.2%) and was completed within the last 8 h in 304 episodes (56.8%). Cleansing agents used were predominantly pH balanced soap or liquid soap and water (n = 379, 71%) in comparison to chlorhexidine impregnated sponges/cloths (n = 86, 16.1%) or other agents such as pre-packaged washcloths (n = 65, 12.2%). In 347 episodes (64.4%) emollients were not applied after the bed-bath. In phase two 12 FGs were conducted (three FGs at each ICU) with a total of 42 RN participants. Thematic analysis of FG transcripts across the three levels of RN ICU experience highlighted a transition of patient hygiene practice philosophy from shades of grey – falling in line for inexperienced clinicians to experienced clinicians concrete beliefs about patient bed-bath needs. Conclusions This study identified variation in process and products used in patient hygiene practices in four ICUs. Further study to improve patient outcomes is required to determine the appropriate timing of patient hygiene activities and cleansing agents used to improve skin integrity.

Smart Grid Test Bed Design and Implementation

Given there is currently a migration trend from traditional electrical supervisory control and data acquisition (SCADA) systems towards a smart grid based approach to critical infrastructure management. This project provides an evaluation of existing and proposed implementations for both traditional electrical SCADA and smart grid based architectures, and proposals a set of reference requirements which test bed implementations should implement. A high-level design for smart grid test beds is proposed and initial implementation performed, based on the proposed design, using open source and freely available software tools. The project examines the move towards smart grid based critical infrastructure management and illustrates the increased security requirements. The implemented test bed provides a basic framework for testing network requirements in a smart grid environment, as well as a platform for further research and development. Particularly to develop, implement and test network security related disturbances such as intrusion detection and network forensics. The project undertaken proposes and develops an architecture of the emulation of some smart grid functionality. The Common Open Research Emulator (CORE) platform was used to emulate the communication network of the smart grid. Specifically CORE was used to virtualise and emulate the TCP/IP networking stack. This is intended to be used for further evaluation and analysis, for example the analysis of application protocol messages, etc. As a proof of concept, software libraries were designed, developed and documented to enable and support the design and development of further smart grid emulated components, such as reclosers, switches, smart meters, etc. As part of the testing and evaluation a Modbus based smart meter emulator was developed to provide basic functionality of a smart meter. Further code was developed to send Modbus request messages to the emulated smart meter and receive Modbus responses from it. Although the functionality of the emulated components were limited, it does provide a starting point for further research and development. The design is extensible to enable the design and implementation of additional SCADA protocols. The project also defines an evaluation criteria for the evaluation of the implemented test bed, and experiments are designed to evaluate the test bed according to the defined criteria. The results of the experiments are collated and presented, and conclusions drawn from the results to facilitate discussion on the test bed implementation. The discussion undertaken also present possible future work.

Review of the progress in thin bed technology for masonry construction

Thin bed technology for clay/ concrete masonry is gaining popularity in many parts of the developed economy in recent times through active engagement of the industry with the academia. One of the main drivers for the development of thin bed technology is the progressive contraction of the professional brick and block laying workforce as the younger generation is not attracted towards this profession due to the general perception of the society towards manual work as being outdated in the modern digital economy. This situation has led to soaring cost of skilled labour associated with the general delay in completion of construction activities in recent times. In parallel, the advent of manufacturing technologies in producing bricks and blocks with adherence to specified dimensions and shapes and several rapid setting binders are other factors that have contributed to the development of thin bed technology. Although this technology is still emerging, especially for applications to earthquake prone regions, field applications are reported in Germany for over a few decades and in Italy since early 2000. The Australian concrete masonry industry has recently taken keen interest in pursuing research with a view to developing this technology. This paper presents the background information including review of literature and pilot studies that have been carried out to enable planning of the development of thin bed technology. The paper concludes with recommendations for future research.

Computational fluid dynamics analysis of a flat plate photocatalytic reactor for storm and wastewater reuse

A computational fluid dynamics (CFD) analysis has been performed for a flat plate photocatalytic reactor using CFD code FLUENT. Under the simulated conditions (Reynolds number, Re around 2650), a detailed time accurate computation shows the different stages of flow evolution and the effects of finite length of the reactor in creating flow instability, which is important to improve the performance of the reactor for storm and wastewater reuse. The efficiency of a photocatalytic reactor for pollutant decontamination depends on reactor hydrodynamics and configurations. This study aims to investigate the role of different parameters on the optimization of the reactor design for its improved performance. In this regard, more modelling and experimental efforts are ongoing to better understand the interplay of the parameters that influence the performance of the flat plate photocatalytic reactor.

Sustainable reuse of storm/waste-water resources : a review on solar photocatalytic purification processes

In recent years, there has been a significant amount of research and development in the area of solar photocatalysis. This paper reviews and summarizes the mechanism of photocatalytic oxidation process, types of photocatalyst, and the factors influencing the photoreactor efficiency and the most recent findings related to solar detoxification and disinfection of water contaminants. Various solar reactors for photocatlytic water purification are also briefly described. The future potential of solar photocatlysis for storm water treatment and reuse is also discussed to ensure sustainable use of solar energy and storm water resources.

Recent developments in photocatalytic degradation of pesticides and phenols in storm and wastewater effluent

The heterogeneous photocatalytic oxidation process offers a versatile promise in the detoxification and disinfection of wastewater containing hazardous organic compounds such as pesticides and phenolic compounds in storm and wastewater effluent. This process has gained wide attention due to its effectiveness in degrading and mineralizing the organic compounds into harmless and often useful components. To develop an efficient photocatalytic process, titanium dioxide has been actively studied in recent years due to its excellent performance as a photocatalyst under UV light irradiation. This paper aims at critically evaluating and highlighting the recent developments of the heterogeneous photocatalytic systems with a special focus on storm and wastewater treatment applications.

The effects of the 2009 dust storm on emergency admissions to a hospital in Brisbane, Australia

In September 2009 an enormous dust storm swept across eastern Australia. Dust is potentially hazardous to health as it interferes with breathing, and previous dust storms have been linked to increased risks of asthma and even death. We examined whether the 2009 Australian dust storm changed the volume or characteristics of emergency admissions to hospital. We used an observational study design, using time series analyses to examine changes in the number of admissions, and case-only analyses to examine changes in the characteristics of admissions. The admission data were from the Prince Charles Hospital, Brisbane, between 1 January 2009 and 31 October 2009. There was a 39% increase in emergency admissions associated with the storm (95% confidence interval: 5, 81%), which lasted for just one day. The health effects of the storm could not be detected using particulate matter levels. We found no significant change in the characteristics of admissions during the storm, specifically there was no increase in respiratory admissions. The dust storm had a short-lived impact on emergency hospital admissions. This may be because the public took effective avoidance measures, or because the dust was simply not toxic, being mainly composed of soil. Emergency departments should be prepared for a short-term increase in admissions during dust storms.

Multifractal analysis of geomagnetic storm and solar flare indices and their class dependence

The multifractal properties of two indices of geomagnetic activity, D st (representative of low latitudes) and a p (representative of the global geomagnetic activity), with the solar X-ray brightness, X l , during the period from 1 March 1995 to 17 June 2003 are examined using multifractal detrended fluctuation analysis (MF-DFA). The h(q) curves of D st and a p in the MF-DFA are similar to each other, but they are different from that of X l , indicating that the scaling properties of X l are different from those of D st and a p . Hence, one should not predict the magnitude of magnetic storms directly from solar X-ray observations. However, a strong relationship exists between the classes of the solar X-ray irradiance (the classes being chosen to separate solar flares of class X-M, class C, and class B or less, including no flares) in hourly measurements and the geomagnetic disturbances (large to moderate, small, or quiet) seen in D st and a p during the active period. Each time series was converted into a symbolic sequence using three classes. The frequency, yielding the measure representations, of the substrings in the symbolic sequences then characterizes the pattern of space weather events. Using the MF-DFA method and traditional multifractal analysis, we calculate the h(q), D(q), and τ (q) curves of the measure representations. The τ (q) curves indicate that the measure representations of these three indices are multifractal. On the basis of this three-class clustering, we find that the h(q), D(q), and τ (q) curves of the measure representations of these three indices are similar to each other for positive values of q. Hence, a positive flare storm class dependence is reflected in the scaling exponents h(q) in the MF-DFA and the multifractal exponents D(q) and τ (q). This finding indicates that the use of the solar flare classes could improve the prediction of the D st classes.

Thin bed masonry system: review and future prospects

Masonry is one of the most ancient construction materials in the World. When compared to other civil engineering practices, masonry construction is highly labour intensive, which can affect the quality and productivity adversely. With a view to improving quality and in light of the limited skilled labour in the recent times several innovative masonry construction methods such as the dry stack and the thin bed masonry have been developed. This paper focuses on the thin bed masonry system, which is used in many parts of Europe. Thin bed masonry system utilises thin layer of polymer modified mortars connecting the accurately dimensioned and/or interlockable units. This assembly process has the potential for automated panelised construction system in the industry setting or being adopted in the site using less skilled labour, without sacrificing the quality. This is because unlike the conventional masonry construction, the thin bed technology uses thinner mortar (or glue) layer which can be controlled easily through some novel methods described in this paper. Structurally, reduction in the thickness of the mortar joint has beneficial effects; for example it increases the compressive strength of masonry; in addition polymer added glue mortar enhances lateral load capacity relative to conventional masonry. This paper reviews the details of the recent research outcomes on the structural characteristics and construction practices of thin bed masonry. Finally the suitability of thin bed masonry in developing countries where masonry remains as the most common material for residential building construction is discussed.

Effects of wearing a pressure redistribution belt while lying in a hospital bed

Bedsores (ulcers) are caused by multiple factors which include, but are not limited to; pressure, shear force, friction, temperature, age and medication. Specialised support services, such as specialised mattresses, sheepskin coverings etc., are thought to decrease or relieve pressure, resulting in a lowering of pressure ulcer incidence [3]. The primary aim of this study was to compare the upper/central body pressure distribution between normal lying in a hospital bed versus the use of a pressure redistribution belt. The study involved 16 healthy voluntary subjects lying on a hospital bed with and without wearing the belt. Results showed that the use of a pressure redistribution belt results in reduced pressure peaks and prevents the pressure from increasing over time.

Effectiveness of powered hospital bed movers for reducing physiological strain and back muscle activation

Battery powered bed movers are becoming increasingly common within the hospital setting. The use of powered bed movers is believed to result in reduced physical efforts required by health care workers, which may be associated with a decreased risk of occupation related injuries. However, little work has been conducted assessing how powered bed movers impact on levels of physiological strain and muscle activation for the user. The muscular efforts associated with moving hospital beds using three different methods; manual pushing, StaminaLift Bed Mover (SBM) and Gzunda Bed Mover (GBM)were measured on six male subjects. Fourteen muscles were assessed moving a weighted hospital bed along a standardized route in an Australian hospital environment. Trunk inclination and upper spine acceleration were also quantified. Powered bed movers exhibited significantly lower muscle activation levels than manual pushing for the majority of muscles. When using the SBM, users adopted a more upright posture which was maintained while performing different tasks (e.g. turning a corner, entering a lift), while trunk inclination varied considerably for manual pushing and the GBM. The reduction in lower back muscular activation levels and the load reducing effect of a more upright posture may result in lower incidence of lower back injury.

Assessing ease of use of the Staminalift bed mover

Battery powered bed movers are increasingly being used within the hospital setting. These energy augmenting devices facilitate the safe movement of beds and patients by healthcare workers. The use of powered bed movers is believed to result in reduced physical efforts on the behalf of staff members, which may be associated with a decreased risk of occupational related injuries. A provisional study was performed in a hospital environment to assess the muscular efforts associated with moving hospital beds both manually and with the aid of a bed mover. The results enable the effects of using bed movers to be quantified.