Safe Handling of Patient Gowns During the COVID-19 Pandemic: An Intelligent System for Patients With Cancer Undergoing Daily Radiotherapy.

BACKGROUND/AIM: Nosocomial infection is a substantial clinical, societal and economic burden, especially during the COVID-19 pandemic. Patients with cancer are required to change into patient gowns before receiving radiotherapy. To improve efficiency and infection control, we designed novel intelligent devices for both gown distribution and recycling. We conducted a pilot study to provide evidence for the device in healthcare quality improvement. MATERIALS AND METHODS: We designed and set up intelligent machines with an infrared sensor for patient gown distribution and recycling. The performance of these machines was assessed by questionnaire survey of patients' perceptions and handling by laundry personnel. RESULTS: We composed a questionnaire to measure patient/personnel satisfaction upon gown handling based on the existing data of our hospital. Two generations of patient gown distribution machines were introduced. One was the novel automated device for both gown distribution and recycling. The other one was the conventional wooden cabinets and/or hamper stands with foot pedals. Survey results showed that approximately 90% satisfaction was achieved with the automated machines. Overall satisfaction with the new soiled gown recycling machines was significantly higher than that with the conventional receptacles (p<0.01). CONCLUSION: The automated patient gown distribution machines safely and efficiently provide patients with suitable gowns. The automated patient gown recycling machine reduces contamination of the gown recycling area. Using these machines improves infection control in the hospital environment and effectively reduces the risk of nosocomial infection.

Impact of breath-hold level on positional error aligned by stent/Lipiodol in Hepatobiliary radiotherapy with breath-hold respiratory control.

BACKGROUND: Respiratory motion management with breath hold for patients with hepatobiliary cancers remain a challenge in the precise positioning for radiotherapy. We compared different image-guided alignment markers for estimating positional errors, and investigated the factors associated with positional errors under breath-hold control. METHODS: Spirometric motion management system (SDX) for breath holds was used in 44 patients with hepatobiliary tumor. Among them, 28 patients had a stent or embolized materials (lipiodol) as alignment markers. Cone-beam computed tomography (CBCT) and kV-orthogonal images were compared for accuracy between different alignment references. Breath-hold level (BHL) was practiced, and BHL variation (ΔBHL) was defined as the standard deviation in differences between actual BHLs and baseline BHL. Mean BHL, ΔBHL, and body-related factors were analyzed for the association with positional errors. RESULTS: Using the reference CBCT, the correlations of positional errors were significantly higher in those with stent/lipiodol than when the vertebral bone was used for alignment in three dimensions. Patients with mean BHL > 1.4 L were significantly taller (167.6 cm vs. 161.6 cm, p = 0.03) and heavier (67.1 kg vs. 57.4 kg, p = 0.02), and had different positional error in the craniocaudal direction (- 0.26 cm [caudally] vs. + 0.09 cm [cranially], p = 0.01) than those with mean BHL < 1.4 L. Positional errors were similar for patients with ΔBHL< 0.03 L and > 0.03 L. CONCLUSION: Under rigorous breath-hold respiratory control, BHL correlated with body weight and height. With more accurate alignment reference by stent/lipiodol, actual BHL but not breath-hold variation was associated with craniocaudal positional errors.