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CENG | CMB | MI > Chapter 2 CENG Equipment Maintenance Program > Flashcards

Chapter 2 CENG Equipment Maintenance Program Flashcards

1
Q

Why the need for equipment maintenance?

A

To promote safe and effective use of medical equipment for patient care

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2
Q

Who provides the function of equipment maintenance?

A

In-house department or external organizations

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3
Q

What does a comprehensive equipment management include?

A
  • A program to control and monitor equipment performance.
  • A program that monitors total equipment maintenance costs.
  • Involve in new equipment acquisition and replacement decisions.
  • Involve in the development of new services.
  • Development of training programs for all equipment users.
  • A quality assurance program.
  • Risk management.
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4
Q

Why are there strict policies and procedures when a hospital needs to purchase
replacement equipment or introduce new technology into its operation

A
  1. To prevent conflict of interests.
  2. To source for most reasonable deal.
  3. To be precise in the specifications.
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5
Q

What are the processes of equipment acquisition?

A

► Justification
► Selection
► Implementation
► Conclusion

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6
Q

What are the 4 processes of justification to replace an existing equipment?

A
  • Cost-effectiveness: if the acquisition of the new equipment can save
    more than the cost of the acquisition in 3-5 years.
  • Safety: existing equipment can no longer operate within the accepted
    standards.
  • Maintenance costs: continual maintenance of existing equipment is
    about 50% of replacement costs.
  • Reasonable period: generally a 7-year guideline.
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7
Q

How to assess a new technology?

A

Assess the technology:
- Does it provide a needed service?
- Will it be accepted?
- Determine the operating and maintenance costs.
- Determine any special requirements like special installation needs

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8
Q

When discussed with groups of staffs to determine the suitability of a technology, what are the different concerns?

A
  • Medical: concerned with the function.
  • Nursing: concerned with the operation.
  • Clinical engineering: concerned with the safety & performance.
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9
Q

What is the last justification process?

A

Submit the proposal including the required budget.
The completed proposal will be submitted to the hospital administration
(i.e. the management) where the proposal will be reviewed for feasibility
according to the hospital’s long-term plans and patient population.

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10
Q

What are included during the selection process of equipment acquisition?

A
  1. Literature review
  2. Call for tender
  3. Preliminary review
  4. Engineering evaluation
  5. Clinical evaluation
  6. Assessment
  7. Final choice
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11
Q

Pros of standardization of equipment? TELA

A
  1. Technical staffs are more familiar with equipment.
  2. Easier to obtain replacement parts.
  3. Less expensive to keep in inventory.
  4. Allows equipment movement to meet varying needs among clinical areas
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12
Q

Cons of standardization of equipment?

A
  1. Hospital is dependent on a limited number of vendors.
  2. Interfere user acceptance if users have little say in the selection process.
  3. Delay the introduction of new technology
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13
Q

What are the 5 implementation processes? PIATF

A
  1. Purchase order (PO)
  2. Installation
  3. Acceptance testing
  4. Training
  5. Follow-Up
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14
Q

What are the objectives of an equipment control program?

A
  1. Equipment that is appropriate and adequate for its purchased intent.
  2. Equipment is properly maintained.
  3. Equipment is included in a planned replacement schedule.
  4. Equipment is monitored for its liability risks.
  5. Equipment is tracked for the costs of repairs and maintenance.
  6. Staff are adequately trained in equipment use
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15
Q

What are the components of an equipment control program?

A
  1. Inventory control.
  2. Hazard awareness.
  3. Quality assurance.
  4. Cost effectiveness
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16
Q

What are the 2 objectives of equipment hazard awareness?

A
  1. To minimize risks to patients and staffs.
  2. To reduce the risk of liability to the hospital
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17
Q

What is quality assurance?

A

 Improve quality of health care:
1. Patient safety and risk management.
2. Evidence-based practice.
3. Continuous learning and improvement.
- Stimulate and improve integration and management of health services.
- Reduce variation in care and health care costs.
- Strengthen the public’s confidence in the quality of health care.

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18
Q

What must be included in a quality assurance documentation? 3R

A
  1. Equipment selection process.
  2. Acceptance tests conducted
  3. Maintenance records
  4. Repairs records
  5. User training records.
  6. All related costs.
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19
Q

What is the priority and PM intervals when EMC ≥ 16?

A

Priority: Life support
PM interval: Minimum twice per year

20
Q

What is the priority and PM intervals when EMC 12 - 15?

A

Priority: Non-life support & direct patient care
PM interval: Minimum once per year

21
Q

What is the priority and PM intervals when EMC ≤ 11?

A

Priority: Non-life support & indirect patient care
PM interval: Preferably once per year.

22
Q

What is the objective of a biomedical equipment maintenance program?

A

Provide safe, calibrated, and operational equipment for delivery of the
best health care possible

23
Q

What are the three known maintenance
strategies that can be implemented for a maintenance program?

A

Preventive Maintenance (PM)
Corrective Maintenance (CM)
Predictive Maintenance (PdM)

24
Q

What is preventive maintenance (PM)?

A

Maintenance strategy based on a schedule or timetable. Utilising the
equipment management code, equipment is evaluated for its function,
physical risk and maintenance requirement. The code assigned determines
the maintenance interval

25
Q

What is corrective maintenance? (CM)

A

Maintenance strategy is one that restores a piece of equipment to operational
status only after an equipment failure or breakdown

26
Q

What is predictive maintenance? (PdM)

A

A maintenance strategy that provides a mean to achieve reliability levels that exceed the performance of a piece of equipment. Predictive analysis
programs are used to confirm possible faults of the equipment and specific
repairs needed even before the failure occurs. This maintenance strategy is usually used for equipment that may compromise its performance or safety to patient. For example, those in the critical care areas

27
Q

What are some problems affecting PdM strategy?

A
  • For accurate prediction, advanced technologies are required to monitor
    every aspect of the equipment.
  • Repaired equipment ≠ ‘as good as new’ condition.
  • Variability in the skills of maintenance personnel.
  • Location and ease of accessibility of defect sites.
  • Complexity of the equipment.
  • Age of the equipment.
  • Quality of replacement parts
28
Q

What are problems affecting an effective PM strategy

A
  • Equipment unavailable: especially when used for daily monitoring or in
    critical care areas.
  • Equipment cannot be located: may be in transit between clinical
    departments.
  • If the PM procedure is too detailed, resources can be wasted.
  • If the PM procedure is too superficial, maintenance may be inadequate.
29
Q

What is the typical Pm schedule?

A

Typical PM interval is 6 to 12 months

30
Q

What are the 4 PM procedure? VCFS

A
  1. Visual inspection
  2. Cleaning
  3. Function testing
  4. Safety testing
31
Q

What is resolution?

A

It is the least count or reading of a parameter which the instrument is capable of indicating. It shows how fine the reading can be.

32
Q

What is sensitivity?

A

Smallest input level of a quantity to which an instrument is capable of responding

33
Q

What is stability?

A

It indicates the instrument’s capability to retain its accuracy over a period

34
Q

What is PPM?

A

(parts per million). A unit of concentration often used when measuring levels of pollutants in air, water, body fluids, etc. One ppm is 1 part in 1,000,000.

35
Q

What are type tests?

A

Tests carried out by approved test houses under tightly specified environmental conditions. Eg The Cardio Vascular Device Testers verify the fatigue life of cardiovascular prostheses such as septal patches, stapling devices and balloon assist devices.

36
Q

What are routine tests?

A

Routine tests should be functionality and electrical safety tests without
subjecting it to undue stress, which would be liable to cause deterioration. Eg. Non-invasive blood pressure (NIBP) simulator: simulates pressure, tests
for leak and over-pressure

37
Q

When must medical equipment undergo routine test? 3

A
  1. Newly acquired equipment prior to being accepted for use (i.e.,
    acceptance testing).
  2. During routine planned preventive maintenance.
  3. After repairs have been carried out on equipment.
38
Q

What is accelerated testing?

A

The concept of accelerated testing is based on using ‘real life’ operational
data and trying to accelerate fault conditions by applying key operational
failure-causing stresses.

39
Q

What are the 3 key operational failure-causing stresses that contribute most
commonly to the impairment of a product’s reliability?

A

-Thermal cycling: induces stresses due to differential expansion of
components and materials.
-Vibration and fatigue: tests mechanical failures due to cyclic stressing.
-Power cycling: turning on and off the electrical power

40
Q

What are the 4 equipment maintenance approaches a hospital can adopt?

A
  1. Contract for services with a variety of equipment manufacturers.
  2. Contract as a shared service group.
  3. Contract with an independent service company.
  4. Create an in-house clinical engineering department.
41
Q

Advantages & disadvantages of In-house clinical
engineering department?

A

Advantages:
 Cost-effective for large facilities.
 Fast response time.
 Familiarity with hospital staff and
protocol.
 Always on-site
Disadvantages:
 Productivity low if not managed
properly.
 Staff turnover and absence can
create issues.
 Small staff number may not
have adequate expertise.
 Initial startup costs high

42
Q

Advantages & disadvantages of equipment
manufacturers?

A

Advantages:
 High expertise for specific
equipment.
 Repair usually accomplished
quickly, once on-site.
 Replacement parts are usually
immediately available.
 No capital equipment costs.
Disadvantages:
 Highest hourly cost.
 Documentation may vary with
different manufacturers.
 Needs coordination if hospital
has equipment from many
manufacturers.
 Representative is not familiar
with hospital personnel and
protocol

43
Q

Advantages & disadvantages of Shared service group?

A

Advantages:
 Cost effective if shared by several
hospitals.
 Many levels of expertise is usually
available.
 Cost saving approach.
 No capital equipment costs
Disadvantages:
 Response time is the longest as
coordination is via the group office.
 Weaker working relationship with
manufacturers or vendors.
 Group office staff turnover and
absence can create issues.
 Representative is not familiar with
each hospital unique environment

44
Q

Advantages & disadvantages of independent service
company

A

Advantages:
 Cost-effective for small facilities.
 No capital equipment costs.
 Most replacement parts are usually
available.
 Proper documentations are usually
provided.
Disadvantages:
Dependent on vendor (i.e. 3rd
party) instead of manufacturer.
 May not have specific equipment
expertise.
 Slow response time.
 Representative is not familiar with
hospital personnel and protocol.

45
Q

What are the typical biomedical equipment maintenance program? 7
BBPERIM

A

 Biomedical equipment safety and quality assurance testing.
 Biomedical equipment repair.
 Pre-purchase evaluation and post-purchase testing.
 Environmental programs.
 Risk management.
 In-service training.
 Management reporting

46
Q

What should a typical biomedical equipment maintenance program evaluated based on?

A

1.Cost
2.Quality
3.Training
4.Response time
5.Continuity of coverage

CENG | CMB | MI (25 decks)

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