guidelines
Assessment of Defects in HVAC Systems Caused by Lack of Maintenance Feedback to the Design Team
Wed, 2015-02-11 11:55 — Fadi A. FatayerResearch has shown that a major part of the heating, ventilation and air-conditioning (HVAC) systems’ operation and maintenance challenges is attributed to the extent of the decisions made during the design stage of projects. Transfer of knowledge from the maintenance team to the design team provides a potential for avoiding the repetition of costly design defects that maintenance teams usually encounter during the functional life of the project. This research has two objectives. The first is to identify and assess the importance of HVAC design defects caused by the lack of maintenance feedback to the design team. These defects have been identified from the literature and interviews with operation and maintenance experts. The study emphasized the importance of all the identified defects based on the judgment of the maintenance experts in 13 public universities in Saudi Arabia. The second objective is to present three sets of validated maintainability guidelines developed to reduce the occurrence of the identified defects in HVAC systems. These guidelines could be considered at three design completion phases (i.e. 30%, 60%, and 90%). This research provides a useful focus to design engineers aiming to design maintainable facilities and maintenance administrators striving to provide high-quality services to facility users.
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Adherence to Guidelines of Antibiotic Prophylactic use in Surgery: A Prospective Cohort Study in North West Bank, Palestine
Thu, 2015-01-29 09:59 — Samar MusmarBackground
Surgical site infection is a major contributor to increased mortality and health care costs globally which can be reduced by appropriate antibiotic prophylactic use. In Palestine, there is no published data about preoperative antibiotic use. This study aims to find the pattern of antimicrobial prophylaxis use by evaluating time of the first dose, antibiotic selection and duration after surgery in three governmental hospitals in North West Bank/ Palestine during 2011.
Methods
After approval of Institutional Review Board, a prospective cohort study included a total of 400 abdominal, orthopedic, and gynecological operations which were performed during study period. Trained clinical pharmacists observed selected 301 operations and followed the patient’s files for the three intended study parameters. Compliance of prophylactic antibiotic administration was evaluated according to published guidelines of the American Society for Hospital Pharmacist. Data were analyzed using SPSS version 16 applying descriptive methods. Relationship between guideline compliance and selected operation factors such as type of surgery, patient care unit, and hospital shift, in addition to provider’s age, gender, experience, and specialization were examined applying chi square test. The statistically significant factors with p < 0.01 were further analyzed using logistic regression model.
Results
Overall compliance for the studied parameters was very low (2%); only 59.8% received their first dose in appropriate time, 18.5% had appropriate antibiotic selection, and 31.8% of patients received antibiotic in appropriate duration. The OBGYN department had much better compliance regarding timing and duration of antibiotic use (P < 0.001), however the proper antibiotic selection was best adhered to for the abdominal surgeries (OR = 3.64, P = 0.002). Male providers were statistically significantly much less adherent to the timing of antibiotic dose (OR = 0.28, p < 0.001), but better adherent in antibiotic selection (OR = 0.191, p = 0.028). Anesthetic technicians showed higher compliance than nurses in timing and duration of antibiotic use.
Conclusions
Lack of guidelines explains the low adherence to appropriate surgical antibiotic prophylaxis in Palestine, with high rate of broad spectrum antibiotic use, long duration and inappropriate time of first dose .We recommend adopting guidelines for prophylaxis and training all health care providers accordingly.
Assessment of Architectural Defects Attributed to Lack of Maintenance Feedback to The Design Team Journal of Architectural Science Review
Thu, 2014-12-11 12:02 — Fadi A. FatayerPlanning for maintenance should start during the design phase and continue throughout the useful life of the building. This research aims to emphasize the significance of the provision of maintenance feedback to the design team during the design development and review stages. The objective of this article is to identify and assess significant architectural defects that are attributed to lack of maintenance feedback to the design team. These defects were identified based on knowledge from international literature and professional practice. The research confirmed the importance of all the identified defects based on the assessment of the maintenance department managers of 13 public Saudi Arabian universities that operate and maintain an extensive infrastructure in their campuses. The paper also recommended a set of guidelines to be considered by the architectural design team at different project design stages (i.e. 30%, 60% and 90% design completion) to reduce the amount as well as the complexities of unplanned maintenance activities in buildings. This article has the potential to raise awareness among professionals in the built-environment community about the significance of the interaction as well as communication between the maintenance and design teams throughout the design phase.
