MEDICAL EQUIPMENT AND UTILITES MANAGEMENT

1. MEDICAL EQUIPMENT AND UTILITES MANAGEMENT Louis Stokes Cleveland, Department of Veterans Affairs Medical Center JCAHO Environment of Care Series Fiscal Year 2009

2. Equipment Management is an important part of the Environment of Care. The following are some of the key points of Equipment Management. • Selecting and Acquiring Medical Equipment • Equipment Incidents • Safe Medical Devices Act • Equipment Training/Competency Verification

3. WORK ORDER SYSTEM The work order system is used when either medical equipment or utility equipment needs repair. Service Chiefs are responsible for requesting engineering work in accordance with MCP 138-008, “Engineering Services” and establishing follow-up controls within their service to assist Engineering Service in the completion of requested work. Most work orders are done using the Electronic Work Order System on VISTA. During business hours, emergency work orders should be phoned in to Engineering Service at extension 4164. Electronic work request 1 Request Electronic Work 2 Edit Electronic Work 3 Electronic Work Order Status 4 Incomplete Work Orders

4. Work Order Menu Options • Request Electronic Work Order • Edit Electronic Work Order • Electronic Work Order Status Check • Incomplete Work Orders Work Order Menu Key Features • Enter work order at any workstation. • On-line access to the status of work order. • ADPAC can issue work order menu.

5. Utility Systems • Engineering Service is responsible for ensuring the proper function, testing, and maintenance of all utilities. • Supervisors are responsible for immediately reporting all incidents involving, or failures of utilities to Engineering Service. • Each Service must have specific utilities outage plans.

6. Oxygen Systems The oxygen distribution system in the hospital makes it easy to supply medical oxygen to patients who need it. In the event of an emergency such as a fire, staff may shutoff oxygen valves in the corridor at the direction of the fire department. The oxygen distribution system does not rely on electrical power to deliver oxygen to patients. Bottled oxygen is provided by AMMS, SPD Section.

7. Oxygen System Oxygen is supplied to many rooms through a central system using piping to outlets at the bedside. On units using piped oxygen, staff should know the location of the medical gas and vacuum system zone valves. These are found in the corridor wall and should be labeled to indicate the rooms which are served. Rooms 4444, 4445, 4446, 4447 If there is a failure with the oxygen system, cylinders such as E-tanks are provided by AMMS, SPD Section.

8. Oxygen System It is unlikely that the oxygen system will be involved in a fire. Most fires involving patient oxygen have occurred at or near the end of the tubing. Disconnecting the tubing at the outlet will remove the oxygen from the fire. In some severe fires, it may be necessary to turn off the oxygen at the valve that controls the flow to one or several rooms. In a fire such as this, your first concern is to remove the patients from the smoke zone to a safe area. The area control valves should only be turned off by order of the fire department.

9. Painting Policy • Engineering Service will try and honor work orders to repaint peeling paint. However, the the following jobs have priority: • Painting as part of an area renovation project. • Painting as part of a management approved 5-year painting plan.

10. Equipment Management Program In order to have an effective equipment management program, three things must occur prior to using a new piece of medical equipment on a patient: Barcode 1. Test • AMMS establishes an inventory record and applies a barcode label. • Acceptance testing by Biomedical Engineering is performed. • Operator training is conducted on the operation, safe use and user maintenance requirements. 2. Train 3.

11. Equipment Management Program Users can determine the status of equipment calibration, maintenance and safety by examining the inspection sticker. When users find an out-of-date sticker, enter an electronic work order. Next inspection due 2/3/03 Possible location of inspection sticker

12. Equipment Management Program Prior to requesting repair service for medical equipment or a patient bed which was assigned to a patient who was in infection isolation, the equipment must be cleaned with an approved disinfectant.

13. Emergency Situations Red telephones are for emergencies. They are a direct line to the operators.

14. Emergency Power Did you know that the red outlets have power during normal operations and when the emergency generator is operating?

15. Reporting Utility System Failure After Hours Utility system failure which occur after administrative hours should be reported to the boiler plant Wade Park at extension 4180 or Brecksville at extension 6184. They are trained to handle emergency situations.

16. Know Your Responsibilities – for equipment and power failures Every supervisor should conduct an annual training needs assessment on each employee. If an employee and his supervisor agree that the employee knows how to operate the equipment he is required to operate to do his job, no additional training is required. You may wish to review emergency procedures when equipment or utilities fail, clinical intervention associated with equipment or utility failures, and how to request medical equipment or utility system repairs.

17. Patient Safety Goals Related to Environment of Care Goal #1: Improve the Safety of Using Infusion Pumps The unintended flow of medication through an IV is known as "free-flow." Uncontrolled free-flow of IV fluids and drugs after removal of IV administration sets from infusion pumps may have a tragic outcomes. Action: Use only equipment protected against “free flow.” We checked all IV pumps and all are protected against free flow.

18. Patient Safety Goals Related to Environment of Care Goal #2: Improve the Effectiveness of Clinical Alarm Systems Implement regular preventive maintenance and testing of alarm systems. Assure that alarms are activated with appropriate settings and are sufficiently audible with respect to distances and competing noise within the unit. Issues • Technical - historical malfunctions. • User Issues - Staff familiarity, understanding what various alarms mean, awareness of alarm enabled/disabled status. • Environmental - High ambient noise, layouts that muffle sound, similar sounding alarms, remoteness from caregivers, too many alarms to distinguish high and low priority alarms leading to caregiver tune-out.

19. INITIAL EQUIPMENT INSPECTIONS Regardless of how medical equipment is brought into the medical center for use on patients, prior to initial use, Biomedical Engineering inspects all medical equipment that is brought into the medical center. Medical equipment may be purchased, rented, leased, on a use agreement, borrowed, clinical trial, it must be inspected by Biomedical Engineering and the clinical staff must be trained on its operation before it can be used with a patient.

20. When equipment wobbles, smokes, heats up, or gives inaccurate results you need to: • Tag and remove the equipment from service. • Report the problem to their supervisor and Engineering Service for repair.

21. Prior to requesting repair service for wheelchairs, medical equipment or a bed that was assigned to a patient who was in infection isolation, the following precaution is taken: • User makes sure the equipment is cleaned with an approved disinfectant.

22. Congratulations, you have completed the Medical Equipment and Utilities Management Training To continue hit your enter key and follow the prompts to take the test.