Offshore work and the work of nurses on board: an integrative review

OBJECTIVETo know the production of theoretical approaches on issues related to offshore work and the work of offshore nurses.METHODIntegrative literature review conducted in the databases of LILACS, BDENF, MEDLINE, SciELO and Index PSI.RESULTSWe selected 33 studies published in national and international journals between 1997 and 2014. The thematic analysis corpus resulted in four central themes: offshore work environment; amid work adversities, an escape; structuring of offshore health and safety services; in search of safe practices.CONCLUSIONThis study contributes to the offshore work of nurses in relation to the nature of work, acting amid adversities and the restless search for safe practices in the open sea.

Patient safety and the prevention of skin and mucosal lesions associated with airway invasive devices

AbstractOBJECTIVETo analyze the care implemented by the nursing team to promote the safety of adult patients and prevention of skin and mucosal lesions associated with the presence of lower airways invasive devices.METHODStudy with qualitative and quantitative approach, descriptive and exploratory type, whose investigative scenarios were adult inpatient units of a hospital in the West Frontier of Rio Grande do Sul. The study subjects consisted of nurses, nursing technicians and nursing assistants.RESULTSA total of 118 professionals were interviewed. We highlight the observed specific care with endotracheal tube and tracheostomy, management and assessment of the cuff and the criteria used to secretion aspiration.CONCLUSIONThere is a superficial nursing work in the patient direct care and a differentiation in relation to the perception of nurse technicians, especially those working in the intensive care unit, who presented major property and view of the patient's clinical status.

Safety Impacts of Pavement Edge Drop-offs, 2006

A vehicle may leave its travel lane for a number of reasons, such as driver error, poor surface conditions, or avoidance of a collision with another vehicle in the travel lane. When a vehicle leaves the travel lane, pavement edge drop-off poses a potential safety hazard because significant vertical differences between surfaces can affect vehicle stability and reduce a driver’s ability to handle the vehicle. Numerous controlled studies have tested driver response to encountering drop-offs under various conditions, including different speeds, vehicle types, drop-off height and shape, and tire scrubbing versus non-scrubbing conditions. The studies evaluated the drivers’ ability to return to and recover within their own travel lane after leaving the roadway and encountering a drop-off. Many of these studies, however, have used professional drivers as test subjects, so results may not always apply to the population of average drivers. Furthermore, test subjects are always briefed on what generally is to be expected and how to respond; thus, the sense of surprise that a truly naïve driver may experience upon realizing that one or two of his or her tires have just dropped off the edge of the pavement, is very likely diminished. Additionally, the studies were carried out under controlled conditions. The actual impact of pavement edge drop-off on drivers’ ability to recover safely once they leave the roadway, however, is not well understood under actual driving conditions. Additionally, little information is available that quantifies the number or severity of crashes that occur where pavement edge drop-off may have been a contributing factor. Without sufficient information about the frequency of edge drop-off-related crashes, agencies are not fully able to measure the economic benefits of investment decisions, evaluate the effectiveness of different treatments to mitigate edge drop-off, or focus maintenance resources. To address these issues, this report details research to quantify the contribution of pavement edge drop-off to crash frequency and severity. Additionally, the study evaluated federal and state guidance in sampling and addressing pavement edge drop-off and quantified the extent of pavement edge drop-off in two states. This study focused on rural two-lane paved roadways with unpaved shoulders, since they are often high speed facilities (55+ mph), have varying levels of maintenance, and are likely to be characterized by adverse roadway conditions such as narrow lanes or no shoulders.

Fact Sheet: Winter Driving Fact Sheet, 2009

The leading cause of death during winter storms is transportation accidents. Preparing your vehicle for the winter season and knowing how to react if stranded or lost on the road are the keys to safe winter driving.

Fact Sheet: Winter Driving Storm Sheet, 2009

The leading cause of death during winter storms is transportation accidents. Preparing your vehicle for the winter season and knowing how to react if stranded or lost on the road are the keys to safe winter driving.

Management of nanomaterials safety in research environment

Despite numerous discussions, workshops, reviews and reports about responsible development of nanotechnology, information describing health and environmental risk of engineered nanoparticles or nanomaterials is severely lacking and thus insufficient for completing rigorous risk assessment on their use. However, since preliminary scientific evaluations indicate that there are reasonable suspicions that activities involving nanomaterials might have damaging effects on human health; the precautionary principle must be applied. Public and private institutions as well as industries have the duty to adopt preventive and protective measures proportionate to the risk intensity and the desired level of protection. In this work, we present a practical, 'user-friendly' procedure for a university-wide safety and health management of nanomaterials, developed as a multi-stakeholder effort (government, accident insurance, researchers and experts for occupational safety and health). The process starts using a schematic decision tree that allows classifying the nano laboratory into three hazard classes similar to a control banding approach (from Nano 3 - highest hazard to Nano1 - lowest hazard). Classifying laboratories into risk classes would require considering actual or potential exposure to the nanomaterial as well as statistical data on health effects of exposure. Due to the fact that these data (as well as exposure limits for each individual material) are not available, risk classes could not be determined. For each hazard level we then provide a list of required risk mitigation measures (technical, organizational and personal). The target 'users' of this safety and health methodology are researchers and safety officers. They can rapidly access the precautionary hazard class of their activities and the corresponding adequate safety and health measures. We succeed in convincing scientist dealing with nano-activities that adequate safety measures and management are promoting innovation and discoveries by ensuring them a safe environment even in the case of very novel products. The proposed measures are not considered as constraints but as a support to their research. This methodology is being implemented at the Ecole Polytechnique de Lausanne in over 100 research labs dealing with nanomaterials. It is our opinion that it would be useful to other research and academia institutions as well. [Authors]

Safety and Mobility Impacts of Winter Weather – Phase I, August 2011

Highway agencies spend millions of dollars to ensure safe and efficient winter travel. However, the effectiveness of winter weather maintenance practices on safety and mobility are somewhat difficult to quantify. Phase I of this project investigated opportunities for improving traffic safety on state-maintained roads in Iowa during winter weather conditions. The primary objective was to develop several preliminary means for the Iowa Department of Transportation (DOT) to identify locations of possible interest systematically with respect to winter weather-related safety performance based on crash history. Specifically, metrics were developed to assist in identifying possible habitual, winter weather-related crash sites on state-maintained rural highways in Iowa. In addition, the current state of practice, for both domestic and international highway agency practices, regarding integration of traffic safety- and mobility-related data in winter maintenance activities and performance measures were investigated. This investigation also included previous research efforts. Finally, a preliminary work plan, focusing on systematic use of safety-related data in support of winter maintenance activities and site evaluation, was prepared.

Driving with Diminished Skills, August 6, 2007

Because driving is a complex task, drivers need to be sure they have the mental and physical capacity for driving safely as they experience changes with aging. Most drivers who are aware of their changing capacity to drive can adjust their driving plans and improve their driving habits to drive safer and longer.

Iowa Driver’s License Renewal, August 3, 2007

One-on-one communication with driver’s license customers is the most valuable tool Driver Services employees use to help drivers stay independent and safe. Driver Services employees understand that a sense of remaining independent, in everything from running errands to shopping to visits with friends, family and doctors, depends on a driver’s license. There are times when Driver Services personnel, or even the drivers themselves, determine it’s time to stop driving. In those cases, people are given a free identification card. There are also times when the DOT must suspend a person’s driving privilege. This can be caused by vision problems, a medical condition or unsafe driving. If the driver cannot be relicensed, DOT personnel make the commitment to work with the individual by providing information about available transportation alternatives. We are providing this information to make the renewal process understandable and less stressful. We hope that by explaining why the DOT screens vision, requires medical information and requests drive tests, and describing how these all relate to highway safety, drivers will know what to expect. Personnel are available to answer questions or discuss concerns at any of the Iowa Department of Transportation or County Treasurer driver’s license sites. Please contact one of the driver’s license stations listed in this booklet.

Curb it-Click it Electronic Communication Devices Prohibited Uses While Driving

This brochure explains Iowa's laws concerning the use of cell phones and other electronic communication devices while driving.

Evaluation of Temporary Ramp Metering for Work Zones, 2012

Ramp metering has been successfully implemented in many states to improve traffic operations on freeways. Studies have documented the positive mobility and safety benefits of ramp metering. However, there have been no studies on the use of ramp metering for work zones. This report documents the results from the first deployment of temporary ramp meters in work zones in the United States. Temporary ramp meters were deployed at seven urban short-term work zones in Missouri. Safety measures such as driver compliance, merging behavior, and speed differentials were extracted from video-based field data. Mobility analysis was conducted using a calibrated simulation model and the total delays were obtained for under capacity, at capacity, and over capacity conditions. This evaluation suggests that temporary ramp meters should only be deployed at work zone locations where there is potential for congestion and turned on only during above-capacity conditions. The compliance analysis showed that non-compliance could be a major safety issue in the deployment of temporary ramp meters for under-capacity conditions. The use of a three-section instead of a traditional two-section signal head used for permanent ramp metering produced significantly higher compliance rates. Ramp metering decreased ramp platoons by increasing the percentage of single-vehicle merges to over 70% from under 50%. The accepted-merge-headway results were not statistically significant even though a slight shift towards longer headways was found with the use of ramp meters. Mobility analysis revealed that ramp metering produced delay savings for both mainline and ramp vehicles for work zones operating above capacity. On average a 24% decrease in total delay (mainline plus ramp) at low truck percentage and a 19% decrease in delay at high truck percentage conditions resulted from ramp metering.

Use of Incentive/Disincentive Contracting to Mitigate Work Zone Traffic Impacts, 2012

Incentive/disincentive clauses (I/D) are designed to award payments to contractors if they complete work ahead of schedule and to deduct payments if they exceed the completion time. A previously unanswered question is, “Did the costs of the actual work zone impacts that were avoided justify the incentives paid?” This report answers that question affirmatively based on an evaluation of 20 I/D projects in Missouri from 2008 to 2011. Road user costs (RUC) were used to quantify work zone impacts and included travel delays, vehicle operating costs, and crash costs. These were computed using work zone traffic conditions for partial-closure projects and detour volumes and routes for full-closure projects. Conditions during construction were compared to after construction. Crash costs were computed using Highway Safety Manual methodology. Safety Performance Functions produced annual crash frequencies that were translated into crash cost savings. In considering an average project, the percentage of RUC savings was around 13% of the total contract amount, or $444,389 of $3,464,620. The net RUC savings produced was around $7.2 million after subtracting the approximately $1.7 million paid in incentives. In other words, for every dollar paid in incentives, approximately 5.3 dollars of RUC savings resulted. I/D provisions were very successful in saving RUC for projects with full-closure, projects in urban areas, and emergency projects. Rural, non-emergency projects successfully saved RUC but not at the same level as other projects. The I/D contracts were also compared to all Missouri Department of Transportation contracts for the same time period. The results show that I/D projects had a higher on-time completion percentage and a higher number of bids per call than average projects. But I/D projects resulted in 4.52% higher deviation from programmed costs and possibly more changes made after the award. A survey of state transportation departments and contractors showed that both agreed to the same issues that affect the success of I/D contracts. Legal analysis suggests that liquidated damages is preferred to disincentives, since enforceability of disincentives may be an issue. Overall, in terms of work zone impact mitigation, I/D contracts are very effective at a relatively low cost.

Evaluation of Mitigation for Safety Concerns on Low-Volume, Unpaved Rural Roads, 2013.

The Institute for Transportation (InTrans) at Iowa State University completed work on an in-depth study of crash history on lowvolume, rural roads in Iowa in December 2010. Results indicated that unpaved roads with traffic volumes greater than 100 vehicles per day (vpd) exhibit significantly higher crash frequencies, rates, and densities than any other class of low-volume road examined, paved or unpaved. The total mileage for this class of roadway in Iowa is only about 4,400 miles, spread over 99 counties in the state, which is certainly a manageable number of miles for individual rural agencies. The purpose of this study was to identify and examine several unpaved, local road segments with higher than average crash frequencies, select and undertake potentially-beneficial mitigation, and evaluate the results as time allowed. A variety of low-cost options were considered, including engineering improvements, enhanced efforts by law enforcement, and educational initiatives. Using input, active support, and participation from local agencies and state and Federal safety advocates, the study afforded a unique opportunity to examine useful tools for local rural agencies to utilize in addressing safety on this particular type of roadway.

Evaluation of Mitigation for Safety Concerns on Low-Volume, Unpaved Rural Roads: Tech Transfer Summary, 2013.

The Institute for Transportation (InTrans) at Iowa State University completed work on an in-depth study of crash history on lowvolume, rural roads in Iowa in December 2010. Results indicated that unpaved roads with traffic volumes greater than 100 vehicles per day (vpd) exhibit significantly higher crash frequencies, rates, and densities than any other class of low-volume road examined, paved or unpaved. The total mileage for this class of roadway in Iowa is only about 4,400 miles, spread over 99 counties in the state, which is certainly a manageable number of miles for individual rural agencies. The purpose of this study was to identify and examine several unpaved, local road segments with higher than average crash frequencies, select and undertake potentially-beneficial mitigation, and evaluate the results as time allowed. A variety of low-cost options were considered, including engineering improvements, enhanced efforts by law enforcement, and educational initiatives. Using input, active support, and participation from local agencies and state and Federal safety advocates, the study afforded a unique opportunity to examine useful tools for local rural agencies to utilize in addressing safety on this particular type of roadway.

Evaluation of Variable Advisory Speed Limits in Work Zones, TPF-5(081), 2013

Variable advisory speed limit (VASL) systems could be effective at both urban and rural work zones, at both uncongested and congested sites. At uncongested urban work zones, the average speeds with VASL were lower than without VASL. But the standard deviation of speeds with VASL was higher. The increase in standard deviation may be due to the advisory nature of VASL. The speed limit compliance with VASL was about eight times greater than without VASL. At the congested sites, the VASL were effective in making drivers slow down gradually as they approached the work zone, reducing any sudden changes in speeds. Mobility-wise the use of VASL resulted in a decrease in average queue length, throughput, number of stops, and an increase in travel time. Several surrogate safety measures also demonstrated the benefits of VASL in congested work zones. VASL deployments in rural work zones resulted in reductions in mean speed, speed variance, and 85th percentile speeds downstream of the VASL sign. The study makes the following recommendations based on the case studies investigated: 1. The use of VASL is recommended for uncongested work zones to achieve better speed compliance and lower speeds. Greater enforcement of regulatory speed limits could help to decrease the standard deviation in speeds; 2. The use of VASL to complement the static speed limits in rural work zones is beneficial even if the VASL is only used to display the static speed limits. It leads to safer traffic conditions by encouraging traffic to slow down gradually and by reminding traffic of the reduced speed limit. A well-designed VASL algorithm, like the P5 algorithm developed in this study, can significantly improve the mobility and safety conditions in congested work zones. The use of simulation is recommended for optimizing the VASL algorithms before field deployment.