Wednesday, April 21, 2010

Initial Research Review:

Riverbend Hospital (initial Photos of things on wheels)



Kayla Hollett Weber, Staff Nurse RN  - Riverbend Hospital

Types of carts: “Precaution carts” (lockable for medications), Food carts, Crash carts (only one on the floor at the end which is problematic)

Notes:

-       Charts are keep outside rooms in holders

-       Lots of time is wasted locating charts, this may be an avenue for cart development

-       Medications are “tubed” over behind the desk from pharmacy

-       Main problem:  moving things and not having them put back

-       Carts and number of carts depend on the size of the hospital and the money they are able to put into equipment. 

-       ER – has unique speed concerns other floors in the hospital do not

-       Problem: 5 star cart bases getting caught on each other

-       Concerns about germ protection

-       Only one crash cart per floor

Jim Olsen, EMT Mountain Rescue/ Ski Patrol - Jackson Hole, WY

Grand Teton National Park, Snow King Resort - Jackson Hole, WY

  Mr. Olsen worked as a mountain rescue trained EMT for about fifteen years living in Jackson Hole, WY. He worked for the Grand Teton National Park and for Snowking resort in the ski patrol. I thought although he worked outside the traditional hospital this research might provide an interesting insight. He told me that he worked in a lot of high stress situations in which people were either quickly taken to the hospital, or treated in the field. I was particularly interested in the stretchers he has used in snow rescues, for climbers and skiers. There seemed to be interesting parallel between these sleds and the carts we are designing. Below is a list of equipment that is routinely used.

         Ski Rescue Sled  (Maneuverability. Ergonomics)

                        Rescue Sled: Inflatable Rescue Litter (Price $1,995)

                                    -Provides level of buoyancy

                                    -Stiffness, insulation

                                    - Ideal for water-ice rescues

                                    -19 lbs – backpackable

                       Basket Stretcher: ($675)

                                    -polyethylene shell with aluminum frame

 1. Technical Equipment List:

• Telemark or Alpine Touring skis

Only bring your telemark skis if you are at least an advanced/intermediate telemark

skier with backcountry experience.

• Telemark or alpine touring boots

• Collapsible ski poles

• Climbing skins (stick-on) that fit your telemark or alpine touring skis

• Avalanche transceiver (475 Megahertz)

• Lightweight snow shovel

• Avalanche probe

• Large backpack (at least 50 liters) with rain cover. Some have built-in rain covers (eg.

Deuter backpacks). Rain covers can also be bought separately.

Otherwise bring a big plastic (garbage) bag as an inside liner for your backpack.

• Climbing harness for glacier travel

• One locking carabiner

• Crevasse rescue equipment, if you are familiar with it.

(Prusik slings, webbing, pulleys, auto-locking device). Your guide will bring a full set.

• Ski crampons (optional, but might make your live much easier in some of the

steeper sections in spring)

• Repair kit for your skis (can be shared between 2 people)

What traits must the tools you use­ have?

  1. Weight
  2. Durability – have to be used again and again
  3. Ergonomics – handles
  4. Mauvarability- have to be able to move over snow on skis
  5. Well marked- intuitive labeling

 Things that need improvement regarding the things you use:

         1.     Bumps effecting injured patients                                                                                                2.     Contamination concerns  - especially on backcountry gear that gets packed back up,             hard to sterilize in the field                                                                                                        3.     In high stress situations colors and shapes that help you find things faster

 Site Observation (unobtrusive): Riverbend Hospital, Eugene OR

 Methods Implemented:

  1. Sitting in main waiting room – observing check in reception
  2. Sitting and observing the ER reception area
  3. Walking around each floors making notes of cart use (also went onto a floor with only custodian equipments which was interesting)
  4. Photo documentation (carts, spaces, hallways, and intriguing images)

 Questions for obtrusive observation (10):                                                                                       I tried to avoid asking participants closed questions in which they automatically respond with yes and no answers. I also attempted to avoid questions that people felt needed to be answered in certain ways. For example if you ask someone if they believe in recycling they will say yes before thinking because society projects that it is a good practice.

 1. When you hear the word “medical cart” what words come to your mind?            

2. Do you need a keyboard to work a tablet?      

3. How much storage space do medical carts need?            

4. In your eyes what are the most difficult things about carts? And using them  

5. How familiar are you with tablet technology, such as the ipad?   

6. Who supplies your medical carts?                   

 7. Can paper files are eliminated? How much information is shored in paper?

8. What daily need to not being met by the carts you are using? 

 9. Is there anything you wish was more mobile?             

10. What carts are used most often?

 Other Resources:

 RN Nurse Boldoc – Sacred Heart Hospital                      

All Med, Incorporated

Medical equipment, supplies, rentals, and repairs

Contact: 541-393-8860 

 PeaceHealth

Contact: 541-686-7300

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