Analysis of upper-limb movements to open glass ampoules and training methods in nursing education

Abstract

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.

Technique to open an ampoule with an “Ampoule Opener” tool

“…The indentation in the neck just below the dot makes the ampoule easy to open. The neck must be broken by hand to access the intravenous solution contained therein; this operations sequence is referred to as ampoule opening 1 . The process of opening the ampoule without a tool can be rough and shaky; the medicine inside can be spilled or even contaminated by small glass shards and can also injure the hand.…”

“…The procedure to open an ampoule is a somewhat risky procedure that can cause injury to the hand 1 . There have been quite a lot of cases of hand injury in the case.…”

Proficiency evaluation of simulation education on the entire tracheal suctioning process using a motion capture system and a catheter control sensing device

“…Recently, motion capture has been used extensively as a nursing research methodology to facilitate visualization of the joint motion of dominant and nondominant upper limbs for operations, such as opening ampoules (Hirano et al, 2019), transfer of patients with occupational lower-back pain from a bed to a wheelchair (Nakagawa et al, 2017;Lin, 2018;Zhou et al, 2021), and ultrasound-guided peripheral intravenous catheter placement (Good et al, 2018). Quantitative parameters, such as performance time, path length, velocity, and acceleration, have been gradually adopted as rigid evaluation criteria for these clinical skills (Zago et al, 2020).…”