An ampoule is a glass cylinder that contains intravenous solutions. Ampoule opening (AO) is performed by nurses on a daily basis, but the procedure involved can cause injuries to the hand as well as contamination of ampoule contents with glass microparticles. As it is currently impossible to completely eliminate the use of glass ampoules, one should learn how to safely perform the AO operation. Herein, we quantitatively analyze the combined seven upper-limb movements of ten experienced participants to clarify the mechanism of AO operations and establish a procedure for safe AO. Unlike current instruction manuals, this study focuses on the joint movements of dominant and nondominant upper limbs rather than on finger positions. A motion-capture system and video cameras are used to analyze the above seven movements of each upper limb. Based on results obtained, the following three guidelines for performing AO operations are derived: (1) supinate the elbow joint to break the ampoule neck; (2) move the dominant hand away from the cutting plane of the ampoule immediately after ampoule breaking without moving the nondominant hand to avoid unnecessary contact of fingers with the cutting plane; (3) synchronize elbow-joint extension with supination in step (1) as the dominant hand is moved away after ampoule breaking. This approach not only ensures safe AO but also helps in learning other skills related to technical nursing education.
Abstract. Quantitative evaluation parameters for care-giving motions were investigated by analyzing three-dimensional motion data of skilled and unskilled caregivers. Subjects were three skilled caregivers, each of whom had over 12 yrs of clinical experience, and four physical therapy students. We recorded a typical care-giving motion between a caregiver and a care-receiver three times for each caregiver/receiver pair with a 3-D motion analysis system (VICON system, Oxford Metrics, UK). We did time-series analyses to extract performance evaluation parameters from observed indexes such as trajectories, velocities, accelerations of the body's center of gravity (COG), jerk-cost, and impulse. The analyzed motion was lifting a patient lying on a bed into the sitting position. The skilled caregivers' operation times were shorter than those of the unskilled caregivers. The COG trajectories of skilled caregivers showed smoother and better reproducibility over the three trials, and the COG velocity curves showed a high single peak at start up. The jerk-cost and impulse of skilled caregivers were lower than those of unskilled caregivers. We found reproducibility and smoothness of movement to be good evaluation parameters for care-giving motions. The measurement indexes observed in this study should be introduced to improve evaluation of the education of unskilled caregivers.
Introduction: The present study aimed to stratify the target students based on their scores from a mock version of the National Physical Therapy Examination, examining the self-learning quantity for each cluster and examined the support required. Methods: The subjects were 54 fourth-year students in the physical therapy department. Subjects were stratified by hierarchical cluster analysis, and self-learning quantity was compared among the obtained clusters. Results: Based on the analysis, subjects were classified into five groups, with significant differences in self-learning quantity and learning time between groups. Furthermore, receiver operating characteristic curve analysis identified the cluster with low academic performance as being in the first year. Discussion: It is necessary to adjust the teaching method to suit the characteristics of each cluster. Furthermore, because the cluster with low academic performance likely had difficulty making progress with self-learning, it is essential to use a multi-faceted teaching approach, such as by instilling an appropriate attitude toward learning when students first enter school.
Objective: We used ultrasound imaging to measure the myotendinous junction displacement associated with the extensor hallucis, and examined its reliability. Methods: We examined the legs of 10 female adults (20 legs) which had no history of external trauma. We measured the displacement of the myotendinous junction under two conditions, namely with the MP joint of the hallux extended at either 0° or 30°. To examine the reliability of the measurements, we used intraclass correlation coefficients and Bland-Altman analysis. Results: Intraclass correlation coefficient was ≥0.8 for both intra-rater reliability (1,1) and inter-rater reliability (2,1). The Bland-Altman analysis did not identify any systematic errors. Conclusion:Measurement of myotendinous junction replacement using ultrasound imaging was highly reliable.
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