مقالات رزومه مهندس ساناز کریم پور

Considering the accreditation of international standards of hospitals and the necessity to improve the safety and quality of patients’ care, this study aimed at evaluating reliability among nurses using predictive analysis of cognitive errors and human event analysis techniques.

The analysis of nurses̓ tasks was done by HTA method. Then, the types of errors and their causes were identified by TRACER method. In the next step, the error probability of each task was calculated by ATHEANA method. In order to calculate the probability of total event, the probability of human error was imported to probabilistic risk assessment.

Factors affecting performance of the nurses were included: the complexity of the work, high workload, nurse’s experience, work environment design, fatigue, anxiety, shortage of the workforce, insufficient time period for doing job, sleep disturbance, and poor lighting and noise pollution. According to the instruction of ATHEANA method, the error probability for each base event was considered 0.001. Given that there are 15 base events, the probability of human error in the heart attack event was calculated 0.015.

The finding of this study was indicated the need for providing required nursing workforce, reducing overtime, scientific planning for nurses’ work shifts and giving practical training and stress management methods in the emergency conditions.

The present study investigated the effect of noise on blood pressure and heart rate of workers in an oil and gas industry in Khuzestan province.

This descriptive-analytical study was conducted on 60 employees of one of the oil and gas industries who worked in administrative, warehouses, and operation units. A demographic questionnaire, a Beurer blood pressure monitor (BC16), and a sound level meter (TES1358) were used for data collection. Blood pressure and heart rate were measured before, during, and after the work. ANOVA and Paired Sample Test were used for data analysis in SPSS software.

Occupational exposure of administrative, warehouse, and operation unit workers to noise were 50-60, 85-75 and 95-85 dBA, and their heart rate was 79.38, 82.12, and 85.73 beats per minute (BPM), respectively. Before exposure to noise the mean heart rate of workers in the operation unit was 82.29±3.58 BPM and after exposure it was 85.73±1.92 BPM, and the difference was statistically significant (P-Value<0.001). The mean blood pressure of exposed to noise workers was significantly higher than that of non-exposed to noise workers (P-Value<0.001). The heart rate of operation unit workers was significantly higher, compared to other studied workers (P-Value<0.001).

Considering the effect of noise on blood pressure and heart rate and the direct relationship between these parameters and cardiovascular diseases, it can be claimed that noise is one of the risk factors of cardiovascular diseases.

The aim of this study was to investigate the causes of low back pain (LBP) among nurses and provide measures to control and correct the risk factors using two methods of risk assessment, MAPO and PTAI.

This cross-sectional study was conducted on a total number of 480 nursing staff working in public hospitals in Khuzestan Province who were selectes using stratified random sampling method. Data were collected though a questionnaire in four sections including Nordic Musculoskeletal Questionnaire(NMQ), a demographic characteristics information form, as well as MAPO and PTAI checklists which were completed using field visits and observations. After completing the checklists, relevant indicators were evaluated at three levels. Data analysis was performed using SPSS software (version 16) as well as Chi-square test and Pearson correlation coefficient.

According to the results, 72.92% of the nurses were suffering from LBP. Based on the evaluations performed by the MAPO method, 16.66% of the respondents were at low-risk level, 60.41% of them at moderate-risk level, and 22.91% of the individuals at high-risk level. However, the findings of the PTAI revealed that 23.95% of the respondents were at risk level I, 52.08% of these individuals at risk level II, and 23.95% of them at risk level III. According to the Chi-square test results, there was a statistically significant relationship between risk levels of both MAPO method and PTAI and LBP.

The results showed that with increasing the indicator levels in bboth MAPO and PTAI methods, the rate of musculoskeletal disorders in the lumbar region increases. Consequently, the accuracy and the appropriateness of these techniques are assured and it was concluded that both techniques are efficient and reliable to determine the risk levels.

This research was conducted with the aim of evaluating human errors among nurses in three hospital wards including emergency, emergency delivery, and cardiac care wards in one of the hospitals of Ahwaz University of Medical Sciences to eliminate or reduce the human errors of nurses and promote the health and safety of patients through recognition of potential.and obvious human errors.

The present applied and cross-sectional study was conducted among all 54 nurses in three wards of a hospital. The data were collected using direct observation of the activities of nurses and supervisors in each ward. After hierarchical analysis of the tasks, human errors were identified and evaluated using standardized plant analysis risk-human (SPAR-H) technique and the worksheets were completed. In the last step, the level of risk was evaluated using the probability and severity of the error.

Injection of blood products has the highest percentage of human errors (74.3%) in the emergency ward. The highest percentages of human errors in the cardiac care unit ere related to duties such as giving injectable drugs (74.3%), blood and its products transfusion (74.3%), and announcement of code and initiation of cardiopulmonary resuscitation (67.8%). Higher probability of human errors in the emergency ward were observed in the receiving drug orders (32.8%) and completing the drug orders (57.1%) which are the main tasks of nurses in this ward. In the delivery emergency ward, blood transfusion had the highest percentage of human errors (74.3%).

The main identified human errors in this study were drug errors, errors related to the transfusion of blood products, and the maintenance of equipment and data storage errors. The main cause of these errors are shortage of time, irregular working shifts, and the limitations and defects in experience and education.

Determining the VO2 max of individuals is of great importance. The VO2 max refers to the maximum oxygen that can be consumed in the body in one minute and depends on factors such as physical conditions, environmental parameters, and physiological characteristics of the individual.. Noise and heat are among the factors influencing VO2 max (also called maximal oxygen uptake or maximal aerobic capacity), which affects the performance of respiratory system, via different ways. Therefore, the purpose of this study was to investigate the simultaneous effect of noise and heat on VO2 max in Ahvaz university of medical sciences’ students  

The present study was conducted on 50 volunteer students from the Ahvaz Jundishapur University of Medical Sciences, Iran. The VO2 max index was measured using the ergometer bicycle test and the Astrand protocol in nine modes of exposure to heat (21, 38 and 48°C), WBGT (18.34, 32.46 and 41.25°C)   and noise (75, 85 and 95 dB (A)). In order to carry out the test according to the Astrand protocol, the person pedaled on the bike for six minutes at a constant load and a speed of 50 rpm to increase the heart rate to more than 120 beats per minute. The heart rate was monitored while working with the ergometer bike using a Polar branded sensor mounted below the individual chest. SPSS vol.22 software, Friedman test and paired t-test were used to analyze the data.

The mean VO2 max in the second test condition (heat:21°C ,  WBGT : 18.34°C ,noise:85 dB)  and the third test condition (heat:21°C ,WBGT : 18.34°C ,noise:95 dB) were not significantly different from the first (normal) mode, but the VO2 max value significantly decreased (P<0.001) from the third mode to higher levels with increasing the levels of heat and noise.

Since one of the objectives of ergonomics is to create an environment in consistent with human capacities, it is essential to have knowledge of VO2 max. Regarding the effect of heat and noise on VO2 max of individuals and also the direct relationship between VO2 max and PWC) Physical Work Capacity (, in order to protect the health of individuals and increase their productivity, it is necessary to carry out control measures in warm and noisy environments.

Undoubtedly, noise and vibration are major problems of industrial world and lot of people are very exposed to these phenomena in their workplace or residential areas. Researchers have shown that exposure to noise may increase the risks related to personal health, like nervous frailty, extreme irritability, muscle cramps, stress and anxiety, dizziness, headache and migraine, anger, loss of body balance, vomiting, pain, hypertension, high blood pressure, cardiovascular problems, deterioration of sleep quality, mental stress, etc. However, the purpose of this study was to assess and control and reduce the risks resulting from noise in the reduction unit 2 of a steel industry. This study was conducted in two steps. 1) Evaluation of noise pollution in the compressor room and its surrounding: For this purpose, total sound pressure level (SPL) and SPLpeak were measured in the places where workers worked or were traveled. The parameters were measured in the mentioned places according to a grid pattern in both the compressor turn on/off. Because the workers exposed to a noise fluctuating, in addition to SPL analysis on the octave-band frequencies to determine critical frequency when the compressor was switched on, the value of Leq was also measured. The critical frequency is very important in noise control issues. The measurements were performed by using sound level meter, model of “B&K 2231.” The apparatus was calibrated before and after measurements by using “B&K 4230 calibrator.” 2) Noise control measurements: After identifying noise leakage paths to outside of the compressor room, noise was controlled in door, wall-fans and roof window area through installing a silencer on the wall-fans and redesigning the door and the roof window using the previous step data. Inside the compressor room, the total sound pressure level and the critical frequency was estimated 106.2 dB (A) and of 250 Hz in the Lin network, respectively. The total sound pressure level in the area around the compressor and the critical frequency were also estimated 94.3 dB (A) and 2000 Hz respectively. Moreover, the value of Leq was more than the threshold value (<85 dB) at all measured stations. In order to control the noise in the area of ​​the fans, considering the noise assessment and the critical frequency, there was used an absorption silencer with glass wool as adsorbent material. To control noise at the door and roof window, there was designed and installed a steel door with dimensions of 3.9 * 2.13 meter and thickness of 1.5 mm which was filled by a noise-adsorbent 40 mm of glass wool and attached to a metal grid. Moreover, to control noise in the roof window was applied a structure with the same specifications, but with the different dimensions (4.2 * 4.2 m and 7 mm mesh diameter). However, the results related to before and after implementation of the control measurements showed an acceptable attenuation in the SPL (91.8%). The average SPL before and after implementation of the control measurements was 95 and 87.2 dBA, respectively which this value was an acceptable level in comparison with background noise, i.e., 86.4 dBA. On the other hand, The slight difference between the mean value of the background sound pressure level and the average of controlled sound pressure level (0.8 dB) is due to factors such as temperature, variations in sound at different positions, generated noise sources (off or on and so no) and the movement of fluids in the pipes and so on.  

The results of the field study indicated that door, window and roof window were identified as the main paths of noise leakage to outside of the compressor room. Therefore, the implementation of the control measurements could be reduced to an acceptable level, but due to high background noise level even after the implementation of the control measurements, the noise level was less higher than the maximum permissible level (85 dB). Therefore, there were presented a few recommendations such as controlling the other sources of noise (e.g. moving fluid through pipes), utilizing the hearing protection devices and how to choose them properly to reduce background noise and the protection of workers against noise.