Objective: Adherence engineering applies human factors principles to examine non-adherence within a specific task and to guide the development of materials or equipment to increase protocol adherence and reduce human error. Central line maintenance (CLM) for intensive care unit (ICU) patients is a task through which error or non-adherence to protocols can cause central line-associated bloodstream infections (CLABSIs). We conducted an economic analysis of an adherence engineering CLM kit designed to improve the CLM task and reduce the risk of CLABSI.
Methods: We constructed a Markov model to compare the cost-effectiveness of the CLM kit, which contains each of the 27 items necessary for performing the CLM procedure, compared with the standard care procedure for CLM, in which each item for dressing maintenance is gathered separately. We estimated the model using the cost of CLABSI overall ($45,685) as well as the excess LOS (6.9 excess ICU days, 3.5 excess general ward days).
Maintenance Best Practices.epub
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Tip and experience: Think at the beginning of a project how you want to handle the maintenance of your solution and business processes (Application Lifecycle) and which level of documentation you will need. You will not get better and cheaper at these knowhow than during a project phase in which all stakeholders are involved.
A little history is essential here. ITIL is a framework of best practices to manage IT operations and services defined in the mid-1980s by the Government of Commerce, UK. ITIL's main objective is to align business and Information Technology, allowing organizations to implement what is relevant to their business. ITIL is just a documented common sense from years of learning from helpdesk managers around the world.
Today, IT Helpdesk is the lifeline of any business from small to large, and most IT managers and helpdesk managers are struggling to have an efficient and productive helpdesk. We will focus on this problem here. As ITIL Service Support offers the best practices framework for IT helpdesk, let us see how ITIL can help helpdesk managers and IT managers. ITIL's IT Service Support Module offers best practices to make sure IT Services are highly available. ManageEngine ServiceDesk Plus Enterprise Edition implements these IT Service Support modules.
The Priority Matrix helps you determine the right priority based on the given values of Business impact and urgency. Helpdesk Managers can configure this one time and ServiceDesk Plus will assign the right priority. This is one of the ITIL Incident Management best practices. However, it is designed to be flexible enough for you to ignore the Priority Matrix and allow technicians and users to define priorities (I wouldn't recommend that)
Based on the changes considered for the next implementation, the changes are scheduled and published. The Change Calendar keeps everyone informed when a particular service will be down for maintenance and when it will be restored.
A lot has changed in 160 years, which is when lead acid batteries were invented. Lead acid batteries are the most common battery type and are low maintenance, 100% recyclable, and may offer the most bang for your buck in terms of price.
Biosafety in Microbiological and Biomedical Laboratories (BMBL) has served as the cornerstone of biosafety practice in the United States since its initial release in 1984. We wish to emphasize that the sixth edition of BMBL remains an advisory document recommending best practices for the safe conduct of work in biomedical and clinical laboratories from a biosafety perspective. The BMBL is not intended to be a regulatory document, although we recognize that some may use it in that way. The core principle of this document is protocol-driven risk assessment; it is not possible for a single document to identify all of the possible combinations of risks and mitigations feasible in biomedical and clinical laboratories. The BMBL should be used as a tool in the assessment and proposed mitigation steps in biomedical and clinical laboratories.
When scheduling secondary site maintenance, consider that the duration of a site-wide or clusterwide outage adds to the time that the standby database lags behind the primary database, which in turn lengthens the time to restore fault tolerance. See Section 8.2, "Determine Protection Mode and Data Guard Transport"for an overview of the Data Guard protection modes.
With Oracle RAC, you can apply certain database patches to one node or instance at a time, which enables continual application and database availability. Interim ("one-off" patches, Patch Set Updates (PSUs), and Critical Patch Updates (CPUs) to database software are usually applied to implement known fixes for software problems an installation has encountered or to apply diagnostic patches to gather information regarding a problem. Such patch application is often carried out during a scheduled maintenance outage.
If multiple instances share an Oracle home, then all of them are affected by application of a patch. Administrators should verify that this does not cause unintentional side effects. Also, you must shut down all such instances on a node during the patch application. You must take this into account when scheduling a planned outage. As a best practice, only similar applications should share an Oracle home on a node. This provides greater flexibility for patching.
Beginning with Oracle Database 11g release 2 (11.2), Oracle ASM is installed when you install the Oracle Grid Infrastructure components, and it shares an Oracle home with Oracle Clusterware when installed in a cluster such as with Oracle RAC. When performing maintenance on the Grid Infrastructure, such as patching or upgrade, it will impact both Oracle ASM and Oracle Clusterware.
Grid Infrastructure upgrade means taking the Oracle Clusterware and Oracle ASM to a later major version, maintenance version, or patch set. Grid Infrastructure upgrade is performed in a rolling manner.
Disks can be added to and removed from Oracle ASM with no downtime. When disks are added or removed, Oracle ASM automatically starts a rebalance operation to evenly spread the disk group contents over all drives in the disk group.The best practices for adding or removing storage include:
For example, if the storage maintenance is to add drives and remove existing drives, use a single ALTER DISKGROUP command with the DROP DISK clause to remove the existing drives and the ADD DISK clause to add the drives:
Use Data Guard SQL Apply for rolling database upgrade when a conventional upgrade cannot complete the upgrade within the maintenance window and the application does not use user-defined types. Oracle Data Guard using SQL Apply is the recommended solution for performing patch set and database upgrades with minimal downtime.
Use transportable tablespaces to migrate to a platform when Oracle Data Pump cannot complete within the maintenance window, and Oracle GoldenGate or Data Guard SQL Apply cannot be used due to data type restrictions.
The recommended best practice is to reorganize tables using the DBMS_REDEFINITION PL/SQL package, because it provides a significant increase in availability compared to traditional methods of redefining tables that require tables to be taken offline. Whether you call DBMS_REDEFINITION manually at the command line or using Oracle Enterprise Manager Reorganize Objects wizard, the entire reorganization process occurs while users have full access to the table, thus ensuring system availability.
Oracle Database 11g supports both local and global partitioned indexes with online operations. When tables and indexes are partitioned, this allows administrators to perform maintenance on these objects, one partition at a time, while the other partitions remain online.
For a scheduled outage that requires an instance, node, or other component to be isolated, Oracle RAC provides the ability to relocate, disable, and enable services. Relocation migrates a service to another instance. Services and instances can be selectively disabled while repair, change, or upgrade is performed on hardware or system software and reenabled after the maintenance is complete. This ensures that the service or instance is not started during the maintenance outage. The service and instance is disabled at the beginning of the planned outage. It is then enabled after the maintenance outage.
When using Oracle RAC, Oracle Clusterware daemons start automatically at the time the node is started. When performing maintenance that requires one or more system reboots or requires that all non-operating system processes be shut down, use the crsctl command to stop and disable the startup of the Oracle Clusterware daemons. After maintenance is complete, enable and start the Oracle Clusterware daemons with crsctl commands.
USC prides itself on the ability to provide top-notch service to our customers before, during and after the sale. USC also believes in regular preventative maintenance and provides detailed information in combination with service visits to prolong the life of all USC treating equipment.
API 653 inspection requirements exist to assist bulk storage tank owners in preserving the life of their assets. API 653 recommends monthly inspections in addition to five year external inspections and ten year internal inspections. As a best practice, bulk storage tank operators should:
Adding cuts or openings to the insulation system increases the likelihood of moisture entering the insulation. That said, we consider the stairs (specifically, underneath the stairs) to be the best location for inspection ports. Steps welded to the tank shell stand out as a moisture entry point because they require many cuts to the insulation. So, it stands to reason that corrosion would most likely form underneath these entry points. More modern stringer stairs mitigate this concern due to the lack of welds or moisture entry points. All that said, inspection ports under stairs do cause inconvenience for access, but this location greatly increases the likelihood of actually finding the corrosion an inspector seeks. 2ff7e9595c
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