A three-dimensional anthropometric solid model of the hand based on landmark measurements.

Hand anthropometry data are largely based on measurements of the hand in an outstretched hand posture and are, therefore, difficult to apply to tool gripping hand postures. The purpose of this project was to develop a representative, scalable hand model to be used with 3-D software drawing packages to aid in the ergonomic design of hand tools. Landmarks (66) on the palmar surface of the right hand of 100 subjects were digitised in four functional hand postures and, from these, 3-D surface models of a mean, 25th and 75th% hand were developed. The root mean square differences in hand length between the hand model and the digitised data for the 25th, 50th and 75th percentile hand were 11.4, 3.2 and 8.9 mm, respectively. The corresponding values for hand breadth were 2.0, 0.4 and 1.4 mm. There was good agreement between distances on the digitised hand and the hand model. The application of this research includes improved ergonomic hand tool design through the use of hand anthropometry reference values developed from the general population using grasping hand postures.

Improved compliance with a gentamicin prescribing policy after introduction of a monitoring form.

OBJECTIVES: Compliance with our local hospital policy for gentamicin administration and monitoring was found to be inadequate on audit. A gentamicin monitoring form was introduced with the aim of improving staff compliance with the policy thus minimizing the risks of toxicity while ensuring adequate dosing. PATIENTS AND METHODS: The initial audit examined the prescribing, administration and monitoring of intravenous gentamicin given to 20 patients. The introduction of a gentamicin monitoring form was prompted by unsatisfactory initial dosing and subsequent monitoring and adjustment of gentamicin doses. RESULTS: Following introduction of the monitoring form, the proportion of appropriate starting doses had increased from 13 out of 20 to 18 out of 20 prescriptions. The timing of initial serum levels was significantly better: 18 timed correctly, compared with 12 in initial audit. Subsequent administration and monitoring appeared more compliant with fewer doses inappropriately omitted and more levels checked appropriately. No improvement was seen in the quality of dose adjustment. CONCLUSIONS: In conjunction with the support and advice of the pharmacy and microbiology departments, the use of a gentamicin monitoring form can improve the quality of intravenous gentamicin use in the hospital setting.