|Year : 2013 | Volume
| Issue : 4 | Page : 217-220
Preventive maintenance of medical equipment in Alzahra Hospital, Isfahan, Iran 2013
Parivash Alikhani1, Hamid Ganji2, Mehdi Abtahi3, Sahar Vesal4, Beheshteh Naghdi5
1 Medical Engineering, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2 Hospital Management, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
3 Medical Equipment Management, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
4 Health Services Management; Research Affairs, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
5 Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
|Date of Web Publication||16-Apr-2014|
BS, Expert of Health Services Managment and Research Affairs, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan
Source of Support: None, Conflict of Interest: None
Introduction: The role of medical devices is increasing every day. So, researchers of this study attempted to help managers and employers by introducing latest medical equipment states and implementing a scientist and accurate method in P.M. for medical equipment. Materials and Methods: This research is an analytical descriptive study and has been performed cross sectional. All medical equipment owned by Alzahra medical center are used in this study by counting method. In this research, we processed 1520 medical equipment, and finally added 1000 medical equipment into P.M. system. We categorized the equipment into 83 categories in 4 categories: Capital/Vital/Scarce/Versatile. In the second stage, we designed a specialized checklist for every category. Finally we completed P.M. instructions for all of the devices based on device's catalogues and biomedical expert's information. Results: Alzahra hospital had 992 pcs equipment consist on: Capital and sensitive (7 pcs)/Vital (11 pcs)/Scarce (49 pcs)/Versatile (636 pcs)/Vital and Scarce (2 pcs)/Scarce and Capital (13 pcs) Vital and Versatile (194 pcs)/Capital and Versatile (17 pcs)/Vital and Capital and Versatile (38 pcs). Status of P.M. system is: Versatile 36%, Scarce 36%, Vital 66% and Capital devices 51%. Discussion: The total of status of P.M. system is Less than 70% comparison of good condition. One of our big achievements in this research was collecting and conducting P.M. for 532 biomedical equipment in 19 types and 28 brands. We conducted these P.M. for Alzahra Medical center and it's exist for their staff and operations.
Keywords: Hospital, medical equipment, preventive maintenance
|How to cite this article:|
Alikhani P, Ganji H, Abtahi M, Vesal S, Naghdi B. Preventive maintenance of medical equipment in Alzahra Hospital, Isfahan, Iran 2013. Int J Health Syst Disaster Manage 2013;1:217-20
|How to cite this URL:|
Alikhani P, Ganji H, Abtahi M, Vesal S, Naghdi B. Preventive maintenance of medical equipment in Alzahra Hospital, Isfahan, Iran 2013. Int J Health Syst Disaster Manage [serial online] 2013 [cited 2019 May 26];1:217-20. Available from: http://www.ijhsdm.org/text.asp?2013/1/4/217/130738
| Introduction|| |
The role of medical devices is increasing every day. Selection of medical equipment for medical centers is of great importance. Proper selection and good maintenance of equipment increase the efficiency of activity treatment. Preventive maintenance (PM) includes control, investigation, and checking all equipment from the viewpoint of quantitative and qualitative medical. Devices are highly important in personnel's health and improve patient's treatment. Despite the importance of maintenance, the guidelines in this area are not properly performed in our country. Results of other studies show that evaluation, control systems, and education of employees had many deficiencies in the equipment maintenance. ,,,,,,
Wang et al.,  announced in their research results that it seems unwise to mandate clinical engineering (CE) professionals to refocus their attention to manufacturers' maintenance recommendations versus active involvement in technology management and, especially, user training and assistance, to address the most frequent root causes of sentinel events. Figueroa and Vallejos in their study  have emphasized that the devices should be functional. Due to this poor performance shown in their results, we suggested that the hospital gradually addresses this situation by replacing 29 nonfunctional equipment items, reinforcing stock with 40 new items, and adding 11 items not available in the inventory but suggested by national guidelines. The results suggest that general medicine inpatient demand has a tendency to increase by time, for example, for general medicine inpatient service the highest increment is obtained by respiratory (12%, RMSE = 8%) and genitourinary diseases (20%, RMSE = 9%). This increment did not involve any further upgrading of the proposed inventory. Also, to improve the maintenance process, some researchers have reviewed different methods and helpful softwares in this field. ,,
Studying and reviewing various research papers show a serious lack of a PM standards in Iran. We chose Alzahra Medical Center because of its big scales. This medical center has 42 specialized department and 1000 beds. This medical center is one of the biggest ones in Iran and the biggest educational medical center in Isfahan and its neighbor states. Alzahra hospital has professional medical equipment in intensive care unit and its operation rooms. So far, no research has been conducted in this area and Alzahra center has problems in P.M. equipment too. So, researchers of this study attempted to help managers and employers by introducing latest medical equipment states and implementing a scientist and accurate method in P.M. for medical equipment.
| Materials and Methods|| |
This research is an analytical descriptive study and has been performed cross sectional. All medical equipments owned by Alzahra medical center are used in this study by counting method. In this research, we processed 1520 medical equipment and finally added 1000 medical equipment into P.M. system. We categorized the equipment into 83 categories and studied the data. This process was done during 2010−2012 in Alzahra Medical Center in three main stages.
In the first phase, we picked out medical equipment. We categorized medical equipment into four categories: Capital equipment/vital/scarce/versatile.
This categorize was based on Food and Drug Administration standards. Explanation of every of the above category are;
The equipment that include the main part of every medical center capital. By using P.M. system for all equipment in this category, we can reduce lots of medical center's costs.
This equipment is purely therapy equipment and having problem on this equipment may cause undesirable result to the patient. This equipment is categorized into high-risk equipment based on standards. Calibrations are crucial for this equipment.
Equipment which number is less than 3 is categorized as scarce equipment. In case of failure, P.M. should do a faster process or company has to provide backup equipment for medical center.
Equipment that exists in 20 or more places is categorized in the versatile equipment. The importance of P.M. for these equipment is because: Most of these equipment are similar in brand and model and creating a checklist and P.M. system can be used for many equipment in every medical center and it will reduce costs. ,,
Gathering information tools in this stage was a self-made check list. This check list has made by researcher. In this research, this checklist has been completed for 83 medical equipments.
In the second stage, we designed a specialized checklist for every category. The checklist was approved by the specialist. Then, we used these checklists neglecting the brand of the device, so that we could have general results. We used our checklist for analyzing available P.M. for every chosen device. This checklist consists of four questions on device's features and its operator and 16 questions on P.M. The checklists were written based on catalogues' information and extra information gathered from medical experts. We should convert the quality of P.M. tasks to a visible and valuable fact, so we tried asking questions that answering them could be our own duty. If 100% of answers are "yes," it shows that we have followed 100% of P.M. task for the device, in the other words, it shows P.M.'s device is at its best situation and does not have any problem. Normally, every "No" in the checklist's answers deducts a percentage of P.M. working. Finally, we completed P.M. instructions for most devices based on device's catalogues and biomedical experts' information and used it on the conclusion of our research, also we used SPSS13, version B for descriptive analyze creation.
| Results|| |
Based on our research, there are 1000 medical devices consists: Capital, vital, scarce, versatile devices, we described these percentage in [Table 1] and [Table 2].
|Table 2: P.M. situation in Alzahra medical center in companion with standards|
Click here to view
We showed name, brand, and P.M. cycle for every researched device in [Table 3].
| Discussion|| |
Based on our research, catalogues are available for most devices in Alzahra medical center; however, these catalogues were incomplete for P.M. instructions. Lack of P.M. instructions information should be covered by devices operators, maintenance team, and companies and lack of guarantee warranty renovation percentage of P.M. Situation for capital and high sensitive devices was 50% of good condition. In this group, computed tomography scan, autoclave, and hemodialysis need more attention in comparison to other devices. Based on these devices' high price, higher attention in P.M. would save maintenance costs and results in its longer life. Based on other's research, in developed countries like Germany, 5% of country's total capital is used for P.M. Though it may seem costly at the first glance, research shows this investment can reduce costs up to 30% in long term. P.M. tasks have been performed to organize medical equipment in USA hospitals from 1980. First stages shows doing P.M. task can reduce costs up to 30%−35%. ,,,
Situation of vital medical equipment P.M. is better than capital devices. Due to its important role in patient's life, but it is not enough and we have to resolve the possible problems in its P.M. tasks. The most important problem for these devices was finding information on its P.M, for operators know only 37% Of device's P.M. Based on this research, it should be done for electrocoauter in the first task. Based on another research, level of knowledge on P.M. is weak in 7% of operators, medium in 56%, good in 14.7%, and very good in 1.3% of them. It is recommended train the operators and staff frequently so that they could work better with the devices. Noori T et al.,  suggest that this task should be done frequently by ward's supervisors and it should be supervised by medical experts or staff of guaranty ward's devices while operators are working with devices.
P.M. status for scarce devices is 37% of good standard based on [Table 2]. There is not program reserve for device in this medical center. According to on their importance, laser, fetal monitoring, EMG, Gama counter should be the first priority in P.M. versatile device list. Another aspect of our research shows that operators of more than 40% of the devices were not trained on equipment's application, alerts, and maintenance, based on its existence (there are more than 600 devices in this category in medical center) learning mentioned contents are crucial. From this category, pulse oximeter, centrifuge, microscope, and operating rooms beds are in high priority.
One of our big achievements in this research was collecting and conducting P.M. for 532 biomedical equipment in 19 types and 28 brands. We conducted these P.M. for Alzahra Medical center and it exist for their staff and operations, as mentioned in [Table 3].
| References|| |
|1.||Webster JG. Medical instrumentation application and design. 4 th ed. Wiley: University of Wisconsin-Madison; 2009:256-61. |
|2.||Ebadifard Azar F. Principles of Hospital Administration and Planning. Tehran: Samat; 2000: 111-18. |
|3.||World Health Organization. Maintenance and Repair of laboratory, diagnostic, imaging and hospital equipment. Geneva: Switzerland; 1994: 25-7. |
|4.||Fesharaki M, Hosseini F, MohammadiNejad G. Maintenance management in five general hospital. Razi J Med Sci 1995;2:53-61. |
|5.||Noori TM, Dabaghi F, Mohamadi R, Haghani H. A survey of maintenance and cost of medical equipment in hospitals associated of Iran university of medical sciences and health services (2000−2001). RJMS 2002;9:445-54. |
|6.||Halbwachs H. Maintenance and the life expectancy of healthcare equipment in developing economies. Health Estate 2000;54:26-31. |
|7.||Hasper K JR. Centralized maintenance responsibilities: A case study. J Clin Eng 1991;16:191-206. |
|8.||Wang B, Rui T, Balar S. An estimate of patient incidents caused by medical equipment maintenance omissions. Biomed Instrum Technol 2013;47:84-91. |
|9.||Figueroa RL, Vallejos GE. Supporting management of medical equipment for inpatient service in public hospitals: A case study. Conf Proc IEEE Eng Med Biol Soc 2013;2013:898-901. |
|10.||Margotti AE, Ferreira FB, Santos FA, Garcia R. Health technology assessment to improve the medical equipment life cycle management. Conf Proc IEEE Eng Med Biol Soc 2013;2013:354-7. |
|11.||Jolly JD, Hildebrand EA, Branaghan RJ. Better instructions for use to improve reusable medical equipment (RME) sterility. Hum Factors 2013;55:397-410. |
|12.||Lynch PK. Managing the costs of medical equipment maintenance: What is the best way? Biomed Instrum Technol 2009;43:270. |
|13.||US. Food and Drug Administration. Product Classification. Available from: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?ID=478 [Last assess 2013 Mar 31]. |
|14.||Ministry of health, treatment and medical education. Equipment Classification. 2009. Available from: www.behdasht.gov.ir [Last accessed 2013Jun]. |
|15.||ECRI Institute. Equipment Classification of FDA. 2009. Available from: www.ecri.org [Last accessed 2013 Jun]. |
|16.||Jadidi R, Bayati A, Arab M. The effect of medical equipment maintenance management system implementation on ValieAsr hospital costs situated in Arak, 2006. Arak Univ Med Sci J 2008;11:418. |
|17.||Amerioun A, Tofighi SH, Zaboli R. Assessing the medical equipment maintenance management at Selected Hospitals Affiliated with the medical sciences universities in Tehran (2003−2005). JHA 2006;9:17-24. |
|18.||Nasiripour A, Jadidi R. Designing a model of medical equipment management for Iranian hospitals, 2007. Arak Univ Med Sci J 2008;11:97-108. |
|19.||Najarian S, Sajadi S, Nazemi F. Introduction to medical device technology. 2003. Available from:WWW.Emvo.who.int/rd/Annual Reports/1997/Chapter 3.htm [Last accessed 2013 Jun]. |
[Table 1], [Table 2], [Table 3]