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

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.