ABSTRACT
BACKGROUND: As millions of workers have shifted to telework, special accommodations for workers with respect to ergonomics may be required to ensure the workforce remains healthy. METHODS: A survey about home office ergonomics and discomfort was sent to faculty, staff, and administrators by email and was completed by 843 individuals. RESULTS: Over 40%of the participants reported moderate to severe discomfort (severe low/middle back pain, moderate discomfort in eyes/neck/head, and discomfort in the upper back/shoulders). Laptops (always and often) were widely used (85%) with most using the laptop monitor (55%) of all respondents. Further, less than 45%of the seating conditions were reported as having adjustable arm rests. CONCLUSION: As teleworking in makeshift offices becomes more common, the risk of significant discomfort and potentially more serious musculoskeletal disorders may result from poor static postures. Companies may need to accommodate workers by allowing them to take home office chairs, external monitors, keyboards, and mice as laptops are insufficient, ergonomically.
Subject(s)
COVID-19 , Ergonomics , Musculoskeletal Diseases/prevention & control , Occupational Diseases/prevention & control , Teleworking , Adult , Computer Peripherals , Humans , Pandemics , SARS-CoV-2 , UniversitiesABSTRACT
Our goal was to improve the efficiency of chemotherapy administration for pediatric oncology patients. We identified prechemotherapy hydration as the process that most often delayed chemotherapy administration. An aggressive hydration protocol, supported by fluid order sets, was developed for patients receiving planned chemotherapy. The mean interval from admission to achieving adequate hydration status was reduced significantly from 4.9 to 1.4 hours with a minor reduction in the time to initiate chemotherapy from 9.6 to 8.6 hours. Chemotherapy availability became the new rate-limiting process.
Subject(s)
Fluid Therapy/nursing , Medical Order Entry Systems/organization & administration , Oncology Nursing/organization & administration , Pediatric Nursing/organization & administration , Total Quality Management/organization & administration , Antineoplastic Agents/administration & dosage , Baltimore , Child , Clinical Protocols/standards , Efficiency, Organizational , Fluid Therapy/standards , Humans , Medication Systems, Hospital/organization & administration , Nursing Audit , Nursing Evaluation Research , Outcome and Process Assessment, Health Care , Program Development , Program Evaluation , Safety Management/organization & administration , Statistics, Nonparametric , Time and Motion StudiesABSTRACT
OBJECTIVE: To implement and evaluate the impact of computerized provider order entry (CPOE) on reducing ordering errors in pediatric chemotherapy. DESIGN: Before-and-after study from 2001 to 2004. SETTING: Pediatric Oncology in an academic medical center. INTERVENTION: Implementation of a CPOE system guided by multidisciplinary failure modes and effects analysis into pediatric chemotherapy. MAIN OUTCOME MEASURES: Completion data on chemotherapy steps of high morbidity/mortality potential if missed (as determined by attending oncologists) from 1259 pre-CPOE paper and 1116 post-CPOE pediatric chemotherapy orders. RESULTS: After CPOE deployment, daily chemotherapy orders were less likely to have improper dosing (relative risk [RR], 0.26; 95% confidence interval [CI], 0.11-0.61), incorrect dosing calculations (RR, 0.09; 95% CI, 0.03-0.34), missing cumulative dose calculations (RR, 0.32; 95% CI, 0.14-0.77), and incomplete nursing checklists (RR, 0.51; 95% CI, 0.33-0.80). There was no difference in the likelihood of improper dosing on treatment plans and a higher likelihood of not matching medication orders to treatment plans (RR, 5.4; 95% CI, 3.1-9.5). CONCLUSION: Failure modes and effects analysis-guided CPOE reduced ordering errors in pediatric chemotherapy and provided data for further improvements.
