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Substantial investments into laboratories, notably sophisticated equipment, have been made over time to detect emerging diseases close to their source. Diagnostic capacity has expanded as a result, but challenges have emerged. The Equipment Management and Sustainability Survey was sent to the Veterinary Services of 182 countries in mid-2019. We measured the status of forty types of laboratory equipment used in veterinary diagnostic laboratories. Of the 68,455 items reported from 227 laboratories in 136 countries, 22% (14,894/68,455) were improperly maintained, and 46% (29,957/65,490) were improperly calibrated. Notable differences were observed across World Bank income levels and regions, raising concerns about equipment reliability and the results they produce. Our results will advise partners and donors on how best to support low-resource veterinary laboratories to improve sustainability and fulfill their mandate toward pandemic prevention and preparedness, as well as encourage equipment manufacturers to spur innovation and develop more sustainable products that meet end-users' needs.
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Laboratórios , Pandemias , Pandemias/prevenção & controle , Reprodutibilidade dos TestesRESUMO
In recent years, the unmanned aerial vehicle (UAV) remote sensing technology has been widely used in the planning, design and maintenance of urban distributed photovoltaic arrays (UDPA). However, the existing studies rarely concern the UAV swarm scheduling problem when applied to remoting sensing in UDPA maintenance. In this study, a novel scheduling model and algorithm for UAV swarm remote sensing in UDPA maintenance are developed. Firstly, the UAV swarm scheduling tasks in UDPA maintenance are described as a large-scale global optimization (LSGO) problem, in which the constraints are defined as penalty functions. Secondly, an adaptive multiple variable-grouping optimization strategy including adaptive random grouping, UAV grouping and task grouping is developed. Finally, a novel evolutionary algorithm, namely cooperatively coevolving particle swarm optimization with adaptive multiple variable-grouping and context vector crossover/mutation strategies (CCPSO-mg-cvcm), is developed in order to effectively optimize the aforementioned UAV swarm scheduling model. The results of the case study show that the developed CCPSO-mg-cvcm significantly outperforms the existing algorithms, and the UAV swarm remote sensing in large-scale UDPA maintenance can be optimally scheduled by the developed methodology.
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Algoritmos , Tecnologia de Sensoriamento Remoto , Tecnologia de Sensoriamento Remoto/métodosRESUMO
Protocols for the sanitation and maintenance of point-of-care ultrasound (US) equipment are lacking. This study introduces the CLEAR protocol (clean, locate, energize, augment supplies, and remove patient identifiers) as a tool to improve the readiness of US equipment, termed US equipment homeostasis. The state of US equipment homeostasis in the emergency department of a single academic center was investigated before and after implementing this protocol, with an improvement in outcomes. These findings demonstrate that the CLEAR protocol can improve US homeostasis. CLEAR can function as a teaching tool to promote homeostasis as well as a checklist to assess compliance.
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Lista de Checagem/métodos , Sistemas Automatizados de Assistência Junto ao Leito , Saneamento/métodos , Ultrassonografia/instrumentação , Serviço Hospitalar de Emergência , Humanos , Manutenção/métodosRESUMO
OBJECTIVE: To evaluate oxygen flowmeters for accuracy and precision, assess the effects of cleaning and assess conformity to the American Society for Testing Materials (ASTM) standards. STUDY DESIGN: Experimental study. METHODS: The flow of oxygen flowmeters from 31 anesthesia machines aged 1-45 years was measured before and after cleaning using a volumetric flow analyzer set at 0.5, 1.0, 2.0, 3.0, and 4.0 L minute-1. A general linear mixed models approach was used to assess flow accuracy and precision. RESULTS: Flowmeters 1 year of age delivered accurate mean oxygen flows at all settings regardless of cleaning status. Flowmeters ≥5 years of age underdelivered at flows of 3.0 and 4.0 L minute-1. Flowmeters ≥12 years underdelivered at flows of 2.0, 3.0 and 4.0 L minute-1 prior to cleaning. There was no evidence of any beneficial effect of cleaning on accuracy of flowmeters 5-12 years of age (p > 0.22), but the accuracy of flowmeters ≥15 years of age was improved by cleaning (p < 0.05). Regardless of age, cleaning increased precision, decreasing flow variability by approximately 17%. Nine of 31 uncleaned flowmeters did not meet ASTM standards. After cleaning, a different set of nine flowmeters did not meet standards, including three that had met standards prior to cleaning. CONCLUSIONS: Older flowmeters were more likely to underdeliver oxygen, especially at higher flows. Regardless of age, cleaning decreased flow variability, improving precision. However, flowmeters still may fail to meet ASTM standards, regardless of cleaning status. CLINICAL RELEVANCE: Cleaning anesthesia machine oxygen flowmeters improved precision for all tested machines and partially corrected inaccuracies in flowmeters ≥15 years old. A notable proportion of flowmeters did not meet ASTM standards. Cleaning did not ensure that they subsequently conformed to ASTM standards. We recommend annual flow output validation to identify whether flowmeters are acceptable for continued clinical use.
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Fluxômetros , Oxigênio/administração & dosagem , Anestesia/veterinária , Anestesiologia/instrumentação , Animais , Falha de Equipamento , Fluxômetros/normas , Fluxômetros/veterinária , Reprodutibilidade dos Testes , Fatores de TempoRESUMO
OBJECTIVE: dimensional guidelines for bedrails have been developed to minimise the risk of patient entrapment within the bed. We examined whether bedrails in a large Irish teaching hospital complied with these standards. DESIGN AND SETTING: survey of 60 accessible beds in six hospital wards. METHODS: a specialised cone and cylinder tool that mimics the size and weight of a small adult neck and head was used to determine gaps in the four zones most associated with entrapment. RESULTS: the number of failures for each zone was 15 beds for zone 1 (any space between the perimeters of the rail); 42 beds for zone 2 (the space under the rail); 41 beds for zone 3 (the space between the inside surface of the bedrail and the mattress) and 13 beds for zone 4 (the space between the mattress and rail at the end of the rail). Failures were more common with hydraulic adjusted than with electric profiling beds. Mattresses that were the wrong size (usually too narrow) or too soft and bedrails that were loose or were poorly maintained accounted for many failures. CONCLUSION: many beds used in our hospital did not comply with dimensional standards to minimise entrapment risks. This emphasises the need for careful selection of patients for whom bedrails are to be used as well as the need for monitoring and maintenance of bed systems.
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Leitos , Hospitais de Ensino , Equipamentos de Proteção , Restrição Física/instrumentação , Acidentes por Quedas/prevenção & controle , Leitos/efeitos adversos , Leitos/normas , Desenho de Equipamento , Falha de Equipamento , Segurança de Equipamentos , Fidelidade a Diretrizes , Hospitais de Ensino/normas , Humanos , Irlanda , Guias de Prática Clínica como Assunto , Equipamentos de Proteção/efeitos adversos , Equipamentos de Proteção/normas , Restrição Física/efeitos adversos , Restrição Física/normas , Fatores de Risco , Ferimentos e Lesões/prevenção & controleRESUMO
Post-COVID, our hospital shifted to online systems using Microsoft Power Platform to mitigate errors and delays. SharePoint and Power Apps manage equipment maintenance records and submissions, enhancing immediacy and transparency. Power Automate automates report generation and reminders, improving task completion rates. Power BI visualizes data for streamlined management. Adjustments to real-time reporting enhanced efficiency, reducing manual efforts and improving completion rates.
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Software , COVID-19 , Humanos , Manutenção , Equipamentos e Provisões HospitalaresRESUMO
While a number of new vaccines have been rolled out across the developing world (with more vaccines in the pipeline), cold chain systems are struggling to efficiently support national immunization programs in ensuring the availability of safe and potent vaccines. This article reflects on the Clinton Health Access Initiative, Inc. (CHAI) experience working since 2010 with national immunization programs and partners to improve vaccines cold chains in 10 countries-Ethiopia, Nigeria, Kenya, Malawi, Tanzania, Uganda, Cameroon, Mozambique, Lesotho and India - to identify the root causes and solutions for three common issues limiting cold chain performance. Key recommendations include: Collectively, the solutions detailed in this article chart a path to substantially improving the performance of the cold chain. Combined with an enabling global and in-country environment, it is possible to eliminate cold chain issues as a substantial barrier to effective and full immunization coverage over the next few years.
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Armazenamento de Medicamentos/métodos , Programas de Imunização , Refrigeração/instrumentação , Refrigeração/métodos , Vacinas/provisão & distribuição , África , Países em Desenvolvimento , Humanos , ÍndiaRESUMO
Many oral and maxillofacial surgical procedures are done in an office-based setting, with many oral and maxillofacial surgeons involved in oversight of equipment maintenance. Goals in equipment management are to prevent harm to patients and staff, stay compliant with current regulations, and increase equipment longevity. This article covers the safety, maintenance, and inspection related to electrical equipment used in the treatment of patients, autoclaves, radiograph machines, nitrous oxide and oxygen medical gases, and required back-up power and lighting. An office should always follow manufacturer's recommendations regarding maintenance and inspection and document policies and monitoring so compliance can be assured.
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Segurança de Equipamentos , Cirurgiões Bucomaxilofaciais , Equipamentos e Provisões Hospitalares/normas , Humanos , Manutenção/normas , Cirurgia BucalRESUMO
Linear accelerator downtimes are common and problematic in many African countries and may jeopardise the outcome of affected radiation treatments. The predicted increase in cancer incidence and prevalence on the African continent will require, inter alia, improved response with regard to a reduction in linear accelerator downtimes. Here we discuss the problems associated with the maintenance and repair of linear accelerators and propose alternative solutions relevant for local conditions in African countries. The paper is based on about four decades of experience in capacity building, installing, commissioning, calibrating, servicing and repairing linear accelerators in Africa, where about 40% of the low and middle income countries in the world are geographically located. Linear accelerators can successfully be operated, maintained and repaired in African countries provided proper maintenance and repair plans are put in place and executed.
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Falha de Equipamento/estatística & dados numéricos , Neoplasias/radioterapia , Aceleradores de Partículas/provisão & distribuição , África/epidemiologia , Humanos , Incidência , Neoplasias/epidemiologiaRESUMO
Since the outbreak of Novel Coronavirus Pneumonia(NCP), hospitals have taken the fight against the virus as its own responsibility, and keep standing in the front line of epidemic prevention and control. The continuous input of anti-epidemic forces in hospitals also brings challenges to the medical supplies support, including the management of protective supplies and the maintenance of medical equipment. In the face of increasing security pressure, the medical materials support team broke the game on multiple fronts. Firstly, the team implements active material procurement strategy, sets material distribution priority according to risk level, releases materials uniformly based on stock and use, and implements traceability management of donated materials to ensure material supply. Secondly, centralized allocation management of equipment, emergency installation, advanced maintenance and emergency maintenance work is effectively completed. Thirdly, disinfection strategies for items and equipment are developed safely and effectively with the aid of disinfection equipment functions. At last, personnel management and training have been strengthened. These measures have provided strong support for the orderly prevention and control of the epidemic.
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Assurance of the safety,reliability and effectiveness of in-use medical equipments is key to improving medical risk management and applied quality of medical equipments of a hospital.By means of regular field survey of in-use medical equipments of the hospital,the authors identified key risk exposures in the current equipment quality control system,and took targeted corrective measurements.Data of routine equipment maintenance and that of appraisal were compared and analyzed.Based on such,appraisal points are set dynamically,and a standardized and customized appraisal program is developed for the safety and quality evaluation of medical equipments,featuring comprehensive coverage and operability.Such efforts effectively supplement daily maintenance work and provide data basis for reliability and usability analysis of medical equipments.
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Objetivo: Identificar as implicações da não manutenção dos equipamentos hospitalares na qualidade do atendimento cirúrgico. Método: Trata-se de uma pesquisa quantitativa, exploratória, descritiva, observacional, realizada em um hospital filantrópico do interior de Minas Gerais. Aplicou-se a técnica de observação direta e a avaliação de registros de manutenção preventiva e corretiva dos equipamentos cirúrgicos. Resultados: Durante o período de observação, verificou-se que os equipamentos que mais apresentaram falhas durante a cirurgia foram: bisturi elétrico, intensificador e foco cirúrgico. Os dados de funcionalidade e manutenção dos equipamentos foram comparados com recomendações do fabricante e com a literatura científica. Conclusão: A não manutenção dos equipamentos cirúrgicos pode prolongar a recuperação pós-operatória, aumentar a morbidade e a mortalidade e levar a um impacto financeiro desnecessário para a instituição. Espera-se que os resultados deste estudo possam motivar a equipe multiprofissional à realização da manutenção preventiva dos equipamentos antes das cirurgias.
Objective: To identify the implications of non-maintenance of hospital equipment for the quality of surgical care. Method: This is a quantitative, exploratory, descriptive, observational study carried out at a philanthropic hospital in the countryside of Minas Gerais. The technique of direct observation was applied, as well as the evaluation of records related to preventive and corrective maintenance of surgical equipment. Results: During the observation period, the equipment presenting most failures during surgical procedures were: electric scalpel, intensifier, and surgical focus. Equipment functionality and maintenance data were compared with manufacturers' recommendations and the scientific literature. Conclusion: Failure in surgical equipment maintenance can prolong patients' postoperative recovery, increase morbidity and mortality, and lead to unnecessary financial impact for the institution. It is hoped that the results of this study motivate the multiprofessional team to perform preventive maintenance of equipment before surgeries.
Objetivo: Identificar las implicaciones del no mantenimiento de los equipos hospitalarios en la calidad de la atención quirúrgica. Método: Se trata de un estudio observacional, descriptivo, exploratorio y cuantitativo realizado en un hospital filantrópico del interior de Minas Gerais. Se aplicó la técnica de observación directa y la evaluación de registros de mantenimiento preventivo y correctivo de los equipos quirúrgicos. Resultados: Durante el período de observación, se verificó que los equipos que presentaron el mayor número de fallas durante la cirugía fueron: bisturí eléctrico, intensificador y foco quirúrgico. La funcionalidad del equipo y los datos de mantenimiento se compararon con las recomendaciones del fabricante y la literatura científica. Conclusión: La falta de mantenimiento del equipo quirúrgico puede prolongar la recuperación postoperatoria, aumentar la morbilidad y la mortalidad y generar un impacto financiero innecesario para la institución. Se espera que los resultados de este estudio motiven al equipo multiprofesional a realizar el mantenimiento preventivo del equipo antes de las cirugías
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Humanos , Calibragem , Manutenção Preventiva , Falha de Equipamento , Equipamentos Cirúrgicos , Estudos de Avaliação como Assunto , TutoriaRESUMO
Objective: To observe and summarize the routine maintenance situation, and research relevant countermeasure and provide the optimal solution based on the problems in maintenance of medical equipment. Methods: To adopt SWOT method to analyze the problem of equipment maintenance, and make effective countermeasures by using relevant statistical methods. Results: The SWOT method that was applied in maintenance work has improved accuracy of maintenance work for equipment, and increased operation rate of equipment and serviceability rate, at the same time, the satisfied degree of medical staffs and patients has been increased. Conclusion: Through SWOT method to analyze the situation of maintenance for equipment, the work key points can be effectively improved, and the blindness and dead ends of equipment maintenance management can be found. Therefore, this method can reduce the labour intensity of maintenance staffs, increase work efficiency, and provide essential guarantee for medical work of hospital.
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Objective:To analyze the demands of maintenance management system of medical equipment, and realize the scientization and normalization of plan design for maintenance management system of medical equipment.Methods: On the basis of current status of maintenance management system of medical equipment, the demands of various department during management process were analyzed, and then a systematic maintenance management plan was designed to face to all of medical equipment in hospital.Results: The preponderances of this system were discussed from three aspects: equipment maintenance, equipment archive and equipment benefit.Conclusion: The application of this system can accelerate the progress of maintenance for medical equipment, enhance maintenance awareness of clinical medical staffs for medical equipment, improve the transparency of equipment scrapping and disposal, and provide effective references for demonstration and purchase of medical equipment.
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Objective To develop a field X-ray vehicle frame motion control simulation circuit based on Proteus.Methods Corresponding component models of Proteus were selected to construct the circuit according to the circuit block diagram.SCM control program was developed and debugged.The frame motion control simulation was executed through dynamic simulation of motor running,simulation results analysis with different parameters and verification of the circuit efficacy.Resnlts DC motor positive and negative rotation controlled by the button was realized,which solved the problems of X-ray vehicle frame motion.Conclusion Proteus can be used to implement system simulation of analog circuit,digital circuit,SCM and peripheral circuit as well as to construct virtual circuit lab.The equipment maintainer enhances medical equipment maintenance based on circuit simulation,circuit model analysis,failure simulation and failure position determination.
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Objective To develop a field X-ray vehicle frame motion control simulation circuit based on Proteus.Methods Corresponding component models of Proteus were selected to construct the circuit according to the circuit block diagram.SCM control program was developed and debugged.The frame motion control simulation was executed through dynamic simulation of motor running,simulation results analysis with different parameters and verification of the circuit efficacy.Resnlts DC motor positive and negative rotation controlled by the button was realized,which solved the problems of X-ray vehicle frame motion.Conclusion Proteus can be used to implement system simulation of analog circuit,digital circuit,SCM and peripheral circuit as well as to construct virtual circuit lab.The equipment maintainer enhances medical equipment maintenance based on circuit simulation,circuit model analysis,failure simulation and failure position determination.
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Objective To apply quality control circle (QCC) to reducing non-timely maintenance rate of medical equipment.Methods QCC was established,and some measures were taken to observe its effect in decreasing non-timely maintenance rate of medical equipment.Results The non-timely maintenance rate fell from 12.1% to 4.5%,and 0.3 million Yuan was saved for the manpower cost.Conclusion QCC decreases the non-timely maintenance rate of medical equipment,increases the efficiency of the maintainer,shortens the downtime of the fault medical equipment,enhances hospital economic benefit and patient satisfaction and provides references for other hospitals.
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Objective To propose a decision tree-based early warning model so as to predict the medical equipment quantity and quality under special conditions to quantize maintenance and detection staffs allocation,components supply,emergency planning and etc.Methods A data set was established based on the verification report,data on performance parameters detection and daily management log,and then underwent pretreatment.A decision tree came into being with the algorithms of ID3,CHAID and etc.The data rule corresponding to the decision tree was transformed into a series of early warning information.The model was verified by applying it to medical equipment usage management.Results The decision tree developed was applied to analyzing a vehicle-mounted water purifying device maintenance and usage records in some logistics support vehicle,and it's found the main factors contributing to the failures included migration distance along non-paved road,ambient temperature and service time.Conclusion The decision tree-based early warning model for medical equipment quantity and quality gains high feasibility and practical values.
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Objective To discuss the practicability of application of fault tree analysis in innovation to electrical system of SL-IE radiotherapy simulator.Methods The structure and principle of the electrical system were analyzed,the fault tree for the electrical system was built,and the qualitative analysis and quantitative analysis to the fault tree were made.The electrical system was innovated with effective redundant method,and the qualitative analysis and quantitative analysis were made after innovation.Theoretical analysis and the actual validation were made for the fault tree of electrical system after innovation.Finally,several notes were provided for the innovation to the similar medical equipments.Results The fault tree analysis method was applied to innovating the electrical system,and theoretical analysis indicated that the failure probability to total system reduced obviously.Actually,the actual effect after innovation also validated the correctness of the theoretical analysis.Conclusion Application of fault tree analysis in innovation to electrical system of SL-IE radiotherapy simulator is practical.But,the selection to the innovation event,the change to maintainence after innovation and the event to innovate carefully should be paid attention to.
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Objective To explore the management methods of medical equipment maintenance. Methods Based on the staffing of hospital engineering technician, the difference between levels of hospitals in medical equipment maintenance management was explored from the aspects of maintenance, preventive maintenance, use training of medical equipment, medical equipment maintenance management system and etc. Results The management methods of medical equipment maintenance were different corresponding to the configurations of the departments of clinical engineering. Conclusion The maintenance management method corresponding to the staffing of hospital engineering technician as well as the correct use of modern medical equipment contribute to insuring the safety and reliability and enhancing the availability and utilization rate.