Aufgrund der Beeinträchtigung eines oder beider Beine sind viele Menschen zur selbstständigen Fortbewegung im Alltag auf ein Hilfsmittel angewiesen. Gehstützen sind das aufgrund hoher Nutzerfreundlichkeit am häufigsten eingesetzte Hilfsmittel bei kurz oder langandauernder Funktionseinschränkung. Die im Vergleich zum normalen Gang erhöhte Belastung der oberen Extremitäten kann in schwerwiegenden Komplikationen wie Thrombosen, Gewebe- und Nervenschäden resultieren. Um diese möglichst gering zu halten, wurden im Laufe der Zeit verschiedene Gehstützenmodelle entwickelt. Ziel der durchgeführten Studie war es, die Belastung der Hände bei verschiedenen hier zu Lande häufig genutzten Gehstützenmodellen und verschiedenen Entlastungen zu erfassen und diese miteinander zu vergleichen. Hierfür zogen wir 26 gesunde Probanden heran, die mit ergonomischen UAG, Arthritis-Gehstützen und anatomischen UAG eine definierte Strecke in festgesetzter, für alle gleicher Reihenfolge liefen. Die zwischen der Hand und dem Gehstützengriff angebrachten Sensormatten erfassten im ersten Studienteil die auf die komplette Hand einwirkende Last und im zweiten Studienteil die Belastung der radialen und ulnaren Hohlhandhälfte separat. Sensorsohlen erfassten zeitgleich die Bodenreaktionskraft. Die Studie zeigte, dass die mit bis zu 70% des Körpergewichts (KG) beim Gehen mit UAG stark belastete Hand mit Arthritis-Gehstützen deutlich entlastet werden kann. Die Belastung konnte auf 16% verringert werden. Eine schwierigere Handhabe muss jedoch in Kauf genommen werden. Bei Beschwerden der Hand, besonders im ulnaren Bereich, sollten anatomische UAG gegenüber ergonomischen UAG bevorzugt werden. Die Belastung der ulnaren Handfläche lag hiermit mit 17% des KG deutlich unter der Belastung mit ergonomischen UAG mit 23% des KG. Die Belastung der radialen Hälfte unterschied sich nicht. Da die Belastung der Hand mit steigender Beinentlastung stieg, sollte die Entlastung möglichst gering und zeitlich kurzgehalten werden. / Due to impairment of one or both legs many people depend on assistive devices for independent mobility in their daily lives. Among these, crutches are the most commonly used aids due to their high userfriendliness in cases of short-term or prolonged functional limitations. The increased load on the upper extremities compared to normal walking can lead to serious complications such as thrombosis, tissue, and nerve damage. To minimize these risks, various crutch models have been developed. The study aimed to define the load on hands using various commonly used types of crutches while walking with different loads on the left leg. 26 healthy participants walked a defined distance in a predetermined, uniform sequence using crutches with ergonomic (eUAG) handles and anatomic handles (aUAG) and arthritis crutches. Sensor mats between hand and handles continuously measured the load transmitted, while sensor soles in the shoes recorded the ground reaction forces simultaneously. The load on the palm and separately the radial and ulnar halves of the palm were analyzed. The study revealed that the hand heavily burdened with up to 70% of body weight while using UAG and can be significantly relieved by using arthritis crutches (16%). However, this comes with a more difficult handling. In cases of hand discomfort, especially at the ulnar half ot the palm, anatomical UAG should be preferred over ergonomic UAG. The load on the ulnar palm was significantly lower with anatomical UAG at 17% of body weight compared to the load with ergonomic UAG (23%). The radial half of the palm had a similar load to bear with both types of handles. Leg relief should be kept as small and as short as possible, because load to bear by the hand increased with greater leg relief.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

Background: Myths, misconceptions and a general lack of information surround the use of gloves and mittens in extreme cold environments. Objective. This study assessed how well an assortment of gloves and mittens performed in a very cold environment. Methods. A convenience sample of gloves and mittens were tested in Antarctica during the winter of 2016 using a calibrated thermometer (range: -148 degrees F to +158 degrees F/-1008C to +70 degrees C) three times over a 0.5-mile distance (similar to 20 minutes). A small sensor on a 10-foot-long cable was taped to the radial surface of the distal small finger on the non-dominant hand. The tested clothing was donned over the probe, the maximum temperature inside the glove/mitten was established near a building exit (ambient temperature approximately 54 degrees F/12 degrees C), and the building was exited, initiating the test. The hand was kept immobile during the test. Some non-heated gloves were tested with chemical heat warmers placed over the volar or dorsal wrist. Results. The highest starting (96 degrees F/36 degrees C) and ending (82 degrees F/28 degrees C) temperatures were with electrically heated gloves. The lowest starting temperature was with electrically heated gloves with the power off (63 degrees F/17 degrees C). Non-heated gloves with an inserted chemical hand warmer had the lowest minimum temperature (33 degrees F/1 degrees C). Maximum temperatures for gloves/mittens did not correlate well with their minimum temperature. Conclusions. Coverings that maintained finger temperatures within a comfortable and safe range (at or above 59 degrees F/15 degrees C) included the heated gloves and mittens (including some with the power off) and mittens with liners. Mittens without liners (shell) generally performed better than unheated gloves. Better results generally paralleled the item's cost. Inserting chemical heat warmers at the wrist increased heat loss, possibly through the exposed area around the warmer.

Nosocomial infections are acquired in health care settings and they can lead to catastrophic health care consequences for patients. These infections can also pose significant financial burdens on society and health care systems. Educating nurses on hand hygiene is essential to reducing infection rates. The research question for the study examined the effectiveness of hand hygiene among nurses in reduction of nosocomial infections and how can health care organizations develop educational strategies to reduce nosocomial infections to improve public confidence in health care systems. The purpose of this study was to educate nurses on how to reduce the incidence of nosocomial infections. The evidence-based practice model for this project was Florence Nightingale's environmental theory. The health belief model was used to identify the reasons for health care culture and how they inspire change. In this study, 2 licensed practical nurses and 2 registered nurses were educated on how to reduce nosocomial infections in acute care settings. Participants then completed a questionnaire to assess their knowledge of hand hygiene as a means of reducing nosocomial infections when caring for patients. All participants agreed that hand hygiene; reduces the risk of contracting a nosocomial infection, suggesting that the incidence of nosocomial infections within acute care settings maybe reduced through this education. This project has potential positive social change by educating first and second year nursing students on the importance of hand hygiene in reduction of nosocomial infections and preventing patients from sustaining further injuries while admitted in acute care settings.

Bakgrund: Vårdrelaterade infektioner är ett problem som tar upp resurser och vårdplatser. Ett av huvudproblemen är brister i handhygienen. Handhygienen ska utföras korrekt för att bedriva en god och säker vård. Det sistnämnda är en kärnkompetens hos den utbildade sjuksköterskor. Händerna utgör en smittväg mellan vårdpersonal och patienter. För att förhindra detta används skyddsutrustning men även handtvätt och handdesinfektion. Trots kunskap om handhygienens betydelse ses bristande tillämpning bland vårdpersonal.Syfte: Syftet är att identifiera faktorer som kan associeras med följsamheten till handhygien hos vårdpersonal inom somatisk slutenvård.Metod: I detta arbete har en litteraturstudie gjorts. Metoden som valts för att svara på syftet  är en kvantitativ metod. Observationsstudier (7) samt kombinerad observation och enkätstudier (3). Databaserna som användes var PubMed och Cinahl för att få fram relevanta artiklar.Resultat: Tio artiklar har sammanställts för att besvara syftet. Resultatet visade att handtvätt görs för sällan och ersätts med desinfektionsmedel. Arbetsbelastning och utbrändhet leder till sämre följsamhet till handhygien. Att handhygien spelar roll beroende av vilket typ av moment som ska genomföras. Följsamheten till handhygien var sämre innan kontakt med patientkontakt än efter. Slutsats: Dålig handhygien har setts på grund av olika faktorer, detta minskar patientsäkerheten genom risken för eventuell vårdrelaterade infektioner (VRI). Genom god handhygien minskar risken för smittbara ämnen vilket främjar både samhället och patienten. / Background: Healthcare related infections are a big problem in our society. This takes up unnecessary resources and hospital beds. One of the main problems is deficiencies in hand hygiene. Hand hygiene has to be performed correctly to provide good and safe care. Safe care is one of the nurses core competencies. Our hands transmit bacteria and viruses infections between the patient and healthcare professionals. To prevent this use protective equipment but also hand washing and hand disinfection. Aim: the purpose is to identify factors that can be associated with compliance with hand hygiene among care staff in somatic inpatient care.Method: In this work a literature study has been used. Observation studies (7) but also combined observation and questionnaire studies (3) was applied. Cinahl and PubMed were used as databases.Result: A total of ten articles were included in the result. The result showed that handwashing is not done as often as it should, and getting replaced with hand disinfection, workload and burnout leads to less compliance with hand hygiene. Hand hygiene plays a role depending on the type of procedures that are going to be performed. Adherens to hand hygiene were worse before patient contact than after. Conclusion: Poor hand hygiene has been due to various factors. This reduces patient safety through the risk of possible healthcare related infections (HRI). Good hand hygiene reduces the risk of infectious substances, which promotes both society and the patient.

Thesis(M. Med. (Public Health Medicine)) -- University of Limpopo, 2019 / Background: Health care workers (HCWs) hands are the most common vehicle for the transmission of health care associated infections (HCAIs) between patients and the health care environment. Hand hygiene is regarded as the most important, simplest, and least expensive means of reducing the burden of HCAIs. However, hand hygiene compliance remains low among HCWs. Aim: To assess the level of knowledge, attitude and self-reported practices (KAP) of HCWs on hand hygiene and associated factors. Method: A quantitative, descriptive study using a pre-tested self-administered questionnaire was conducted among HCWs of Pietersburg Hospital. Data collection was carried out between January and February 2018. KAP scores were summarised into means, standard deviations and percentages. Chi-square and Fisher’s exact tests were used to determine association between KAP scores and selected independent variables (gender, age, profession, experience, discipline and training). Results: There were 324 respondents, mostly females (74.3%), <40 years (70.6%) and predominantly nurses (52.4%). Majority had moderate knowledge (79.3%), positive attitude (88.8%) and good practices (87.9%). Respondents had knowledge gaps on HCAIs, WHO “Five (5) moments for hand hygiene” and alcohol based hand rub. Association was found between respondent’s KAP scores and age (p<0.05). Nursing profession was associated with good practices (p=0.000). Knowledge and attitude were associated with years of clinical experience (p<0.05). Positive attitude (p=0.019) and good practices (p=0.000) were associated with training in the last 3 years. No significant relationship was found between KAP and undergraduate training. Conclusion: Most respondents had moderate knowledge, positive attitude and good practices. Respondent’s variety in KAP scores and associated factors indicate that a multimodal, multifaceted improvement approach should be undertaken to address KAP gaps.

Abstract Miscommunication or omission of critical patient information contributes to preventable medical errors that result in 98,000 patient deaths each year. The hand-off communication process creates a critical time for the patient as necessary information for the continuity of care must be communicated. The purpose of this practice project was to evaluate the nurses' perception of the current hand-off communication process before and after an educational intervention and implementation of the I-5 Verification of Information Tool. Registered nurses were asked to complete a pre survey of their perception of the current hand-off communication process, followed by an educational power point describing the I-5 Verification of Information Tool. Participants utilized the I-5 Verification of Information Tool during hand-off over a 3-week period, and then were asked to complete a post survey to evaluate the nurses' perception of the hand-off process including of the I-5 Verification of Information Tool. A paired t test was used to determine if there was a difference in the nurses' perception of the current hand-off communication process before and after an educational intervention and implementation of the I-5 Verification of Information Tool. Although there was no statistically significant difference in the pre- and post-survey scores, post survey results demonstrated clinical significance. This project has implications for positive social change by addressing nurse communication as a method to improve the quality of hand-off reports, which has the potential to reduce medical errors and improve patient outcomes.

Background: Hand hygiene is now, more than ever, one of the most important factors to minimize spread of infection. In low income countries like Lesotho between 6% - 19% of patients contract at least one healthcare associated infection. Compared to between 3% - 10% in high income countries. Objective: The aim was to describe how healthcare professionals experience and conduct basic hand hygiene procedures at a hospital in Lesotho. Method: The study was conducted using a qualitative content analysis with a manifest level of abstraction and an inductive approach. Result: The results showed in our final categories; Healthcare professionals perceive different views on the risk for contamination, Healthcare professionals described hand hygiene as important although there are hindrances, and Healthcare professionals stated that basic hand hygiene need support from management for good compliance. That healthcare professionals did not always perform basic hand hygiene the way it was supposed as low budget or lack of knowledge was an obstacle. Conclusions: There are many problem areas, such as cost, availability and knowledge although the personnel are interested, resourceful and willing to make the best of any situation they come across.

Ett av problemen som företag möter om de vill börja tillverka handskar är att det inte finns standarder kring mått eller konstruktion. Det finns en praxis på breddgradering som följer handens omkrets i tum, men ingenting i längd. Denna rapport undersöker olika längdgraderingar som används på den svenska marknaden. Genom att mäta och jämföra olika tillverkares handskar hittades tre olika längder på fingrar i storlek 8 och tre olika graderingar från dessa storlekar: 15 mm, 10 mm och 5 mm. Dessa graderingar delas lika över finger och handflata. Handskar i storlek 6-11 har sytts upp och provats av 28 personer, både män och kvinnor, som sedan svarat på en enkät om vilken handske de föredrog. Från enkäten kan utläsas handens mått i längd och omkrets, vilka handskar man provat, vilken man tyckte satt bäst samt vad man vill veta vid köp av handskar för att underlätta köpet. Av de som provat grundstorlek 8 föredrog fyra personer en längd på 8,5 cm på långfinger medan en person föredrog 8 cm. Ingen av personerna som provade föredrog en längd på 9 cm. För de andra storlekarna, graderade från en grund med fingerlängd 8,5 cm, föredrogs den gradering som gavs längst fingrar, följt av graderingen på 10 mm. Från detta kan läsas att det finns ett behov av olika längder för varje storlek och för att underlätta för kunden behövs tydliga måttlistor som informerar vilka mått handsken kommer passa. / One of the problems that companies who wishes to go into glove production faces today, is that there is no standardized measurements or constructions. There is a praxis for width grading, where you measure the hands circumference around the knuckles, in inches, but the are no such praxis for the length of the glove. This study compares different length gradings that are available on the Swedish market. By measuring and comparing different glove brands, three different finger length variations were found for size 8 as well as three different grading intervals between the sizes; 15mm, 10mm and 5mm. The grading intervals are divided equally between fingers and palm. Gloves in sizes 6-11 were constructed, sewn and finally fitted on 28 test subjects, both male and female. The subjects also submitted a questionnaire about their hand measurements, which gloves they tried on, which glove they preferred and if they would like any information about which body measurements the glove is fitted to when buying gloves. For size 8 it was found that four subjects preferred a finger length of 8,5 cm on the middle finger while one preferred the shorter length of 8cm. For the other sizes, graded from a basic size of 8,5 cm at finger length, the preferred grading was the one that gave the glove the longest fingers, followed by the grading of 10mm. From these results it is clear that there is a need for different lengths for each glove size and that the customer would appreciate a measurements chart that shows what hand measurements the glove will fit.

The hand is one of the most complex of all of the anatomical structures in the human body. It has been found that hand injuries are among the most frequent injuries that occur to the body, predominantly during industrial activities. It has therefore been concluded that more research is needed into protective factors, such as glove use. The design features of a glove emphasise either protection or performance. There is often a trade-off between increased safety and performance capability when donning gloves. It has been determined that gloves which are fitted and comfortable for the worker may provide the best compromise between protective functions and decreased performance. This investigation aimed to assess the influence of glove fit on the performance attributes of industrial tasks, as well as on the responses of the human operator. Glove fit was analysed as 35 male participants donned three different glove sizes during each test, including a best-fitting glove, a glove one size smaller than best-fitting, and a glove one size larger than best-fitting. For each glove size, gloves of two differing materials were tested, namely nitrile and neoprene. A barehanded condition was also tested, totalling seven gloved/barehanded conditions for each test. The seven conditions were assessed in a laboratory setting in a battery of tests. This consisted of components of task performance, including maximum pulling and pushing force, maximum torque, precision of force, tactility, speed and accuracy and dexterity. The performance responses were recorded, as well as participants’ perceptual responses using the Rating of Perceived Exertion scale, and muscle activity. Six muscles were selected: Flexor Digitorum Superficialis, Flexor Pollicus Longus, Extensor Carpi Ulnaris, Extensor Carpi Radialis, Flexor Carpi Ulnaris and Flexor Carpi Radialis. The results revealed that glove fit does affect certain spects of performance, and influences human operator responses for selected task components. Furthermore, discrepancies were distinguished between orking barehanded and working with an optimally fitted glove. There was also a glove material effect established. Overall, it was found that muscle activity when exerting maximum force in a pushing and pulling direction was optimal with the nitrile glove material. Maximum torque performance was enhanced with the use of a best-fitting glove, as compared with an ill-fitting glove or barehanded work. Force precision was preferable when barehanded, as opposed to the tactility task which rendered optimal results with a best-fitting glove. The same was found for speed and accuracy results, as glove fit appeared to have no effect on performance, but performance was improved when participants were barehanded. Dexterity performance was the most conclusively influenced by the conditions, resulting in barehanded performance being optimal. However, should a glove be necessary for a given task, an optimally-fitted glove which is of a thinner material would be recommended. It is necessary to distinguish the performance components of a task within industry and select the most appropriate glove for optimal performance and the least risk of overexertion.