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Journal of Parenteral and Enteral Nutrition ; 47(Supplement 2):S213-S214, 2023.
Article in English | EMBASE | ID: covidwho-2323720


Background: Institutions across the country are experiencing delays in receipt of essential infant formula and feeding supplies due to a supply chain crisis. The supply chain crisis commenced during the COVID-19 pandemic and has continued into present day, late 2022. The supply chain crisis led to an unstable supply of ready to feed (RTF) infant formulas for a children's hospital within a medical center containing a neonatal ICU, pediatric ICU, pediatric floor and newborn nursery. RTF formulas are the recommended inpatient infant feeding due to their sterility. Method(s): To address these RTF formula supply challenges, interprofessional leadership from Clinical Nutrition, Nursing and Supply Chain developed a local infant formula committee. The committee convened based on the needs of the institution, ranging from daily to weekly beginning October 2021 to present day. A shared, live spreadsheet allowed for real time inventory of RTF formula on the Nursing units and amount of product pending receipt in supply chain. Upon identification of low RTF supply, increased usage or RTF outage, the committee implemented a three-tiered action plan for each unit. For the first tier, the formula roomdiluted a higher calorie RTF liquid with water to the desired calorie density (example RTF 24 to RTF 20 calorie/oz). The medical team had an infant formula substitution list to guide feeding alternatives for specialty preparations. In the second tier, the formula room prepared stock formula for each unit daily, with a 24-hour expiration time, to accommodate potential for rapid census changes outside of the formula room operation. As a third layer of safety, powder emergency stock was pre-measured and sent with instructions for Nursing to reconstitute with sterile water, in a dedicated space, if all stock RTF formula was used. The powder emergency stock expired in 30 days, which allowed for a longer shelf life than the stock RTF formula. Result(s): It is practical for institutions without a formula room to implement similar processes using dedicated infant formula preparation space and storage. It also worth mentioning during this time there was a national shortage of powdered infant formulas due to a recall issued in May of 2022 by a major formula manufacturer. The national shortage included elemental powdered formulas for which there is no RTF alternative. Management of elemental formula outages were managed on a case-by-case basis by the Clinical Nutrition department. The Committee also convened to discuss allocations and identify substitutions for other neonatal and pediatric specialty items including sterile water, feeding preparation bottles, ENFit syringes and syringe caps, breastmilk collection containers and infant feeding nipples. Conclusion(s): Using this three-tiered process, the medical center provided sterile RTF formula to infants when available, remained consistent with best practices, predicted inventory needs consistent with usage and prevented waste of powdered infant formula in a time of scarcity. Technology and the anticipatory interprofessional leadership using a three-tiered action plan equipped the medical center for this most extraordinary infant formula crisis nationally.

1st International Conference on Electrical, Electronics, Information and Communication Technologies, ICEEICT 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1874283


In the year 2020, countries were in a race against the spread of Covid-19, leading to major deficiencies in the areas of health, economy, and construction. For this reason, the robotics industry emerged as a viable and safe option to perform important and critical tasks in different sectors, one of them is the real estate. For this reason, a robotic arm was designed to wall painting, this study is supported by the mechatronics engineering department of the Universidad Tecnológica del Perú. The designed robot called: 'UTP-ISR01' has 6 axes and a linear displacement of 2.8 m with turns of 0.24 sec/60°. For the calculation of the forward kinematics the Denavit Hartenberg method was used, then the homogeneous transformation matrices were used to calculate the rotation and translation movements of the robotic manipulator. With the equations identified in the inverse kinematics, the positions and orientations of the robot were plotted, as well as the dimensions of the working area. The CAD design was carried out with engineering software, such as Autodesk Inventor for the mechanical design and assembly of the parts. In addition, with RoboDK software, kinematic simulations and analysis were performed. In conclusion, the robotic arm will reduce the delivery times of the apartments built by the real estate companies. © 2022 IEEE.

Annals of Behavioral Medicine ; 55:S121-S121, 2021.
Article in English | Web of Science | ID: covidwho-1250360