Hospital Medical Equipment Research Articles

ZAMBIA’S MENTAL HEALTH PATIENTS: VICTIMS OF UNSPEAKABLE INFRASTRUCTURE CHALLENGE IN ZAMBIA’S HEALTH SYSTEM

Purpose: This article attempts to examine the critical role that physical health infrastructure and associated facilities play in the delivery of effective integrated primary health care services for mental patients in Zambia. The working definition for ‘physical infrastructure’ in the paper relates to wider capacities in form of hospital buildings, bed spaces, medical equipment, and professional healthcare personnel, among other elements that facilitate effective operations of a health facility.
 Methodology: This study has used both quantitative and qualitative data from various sources to map the debate on the impact of inadequate infrastructure on mental health patients in Zambia’s health system. 
 Findings: Inadequate health infrastructure has had a negative impact on the well-being of mental health patients and other sectors of the Zambian society. The entire country has only one ill-resourced main hospital, offering mental health services and has been overwhelmed by a combination of insufficient infrastructure and effects of COVID-19 pandemic.
 Unique contributions to theory, practice, and policy: For the health reforms to be effective, it is recommended that the conceptual integrated health system in Zambia be anchored on universal allocation of adequate resources and operationalization of mental health policies that genuinely connect with social determinants of mental health issues within communities. The involvement of non-governmental organizations providing an interface between communities and governments should be supported by organizational and multi-institution capacity and coordination. A systems theory informed this study and has been elaboratively discussed in the second chapter of this paper

Optimal control analysis for a Candida auris nosocomial infection model with environmental transmission

In this paper, we propose a mathematical model to investigate the role of environmental reservoirs in the transmission dynamics of the rising Candida auris infections in nosocomial settings. The ability of the pathogen to resist commonly used hospital disinfectants ensures its persistent contamination of hospital surfaces and medical equipment readily leading to patient colonization. Colonized patients shed the pathogen into their surroundings thereby increasing the fungal concentration in the hospital environment. We analyze the model for its basic mathematical properties, perform sensitivity analysis, and formulate an optimal problem to determine the efficiency of control interventions, namely, standard transmission precautions, proper laboratory identification, and isolation of patients identified with colonization in reducing the contamination and transmission of C. auris infections. We characterize the optimal controls using Pontryagin's Minimum Principle and further prove the uniqueness of the optimality system. Numerical simulations are performed to substantiate the theoretical analysis, and the results are illustrated graphically.

Application of Intelligent Medical Equipment Management System Based on Internet of Things Technology.

The management level of medical equipment is an important index to evaluate the modernization degree of hospitals and it is also the basic element of medical and scientific research work, which plays a key role in the development of medical clinical science. Under the background of the rapid development of modern Internet of Things (IoT) technology, hospitals should be fully aware of the role of Internet of Things technology in hospital medical equipment management. With the increasing demand for refined management of medical equipment in hospitals, the application potential of the Internet of Things technology in medical equipment management has gradually become prominent. The management of medical equipment in a hospital is an important part of the management of the hospital, which is related to the medical level, service quality, and economic benefits of the hospital. In this paper, we have analyzed current problems in the management of medical equipment in hospitals, discussed the application of the Internet of Things technology in the management of medical equipment, and promoted the management of medical equipment to be more intelligent and automated. Experimental results have verified that the proposed scheme could be one of the trustworthy automated systems, preferably technology assisted, for the proper management of the medical equipment particularly in hospitals.

Antibacterial Films Based on MOF Composites that Release Iodine Passively or Upon Triggering by Near‐Infrared Light

AbstractMultidrug‐resistant bacteria have become a global health problem for which new prophylactic strategies are now needed, including surface‐coatings for hospital spaces and medical equipment. This work reports the preparation and functional validation of a metal‐organic framework (MOF) based composite for the triggered controlled release of iodine, an antimicrobial element that does not generate resistance. It comprises beads of the iodophilic MOF UiO‐66 containing encapsulated gold nanorods (AuNRs) coated with a silica shell. Irradiation of the AuNRs with near‐infrared light (NIR) provokes a photothermal effect and the resultant heat actively liberates the iodine. After validating the performance of this composite, it is integrated into a polymer for the development of antibacterial films. This work assesses the adsorption of iodine into these composite films, as well as its passive long‐term release and active light‐triggered. Finally, this work validates the antibacterial activity of the composite films in vitro against gram‐positive and gram‐negative bacteria. The findings will surely inform the development of new prophylactic treatments.

Characterization and Maintenance of Hospital Equipment: A Case Study on the Institute of Molecular Medicine Jo˜ao Lobo Antunes

Objective: The objective of this study was to conduct a study on the characterization and maintenance of equipment in a hospital environment and apply it in the case study conducted as part of an internship at the Instituto de Medicina Molecular João Lobo Antunes (iMM), with a duration of eleven months. This work contributed to the identification of improvements to be applied in the Safety and Compliance Department, in the maintenance, calibration, and monitoring of medical-hospital equipment (MHE), to improve their reliability and efficiency, the reduction of costs and downtime, and the probability risk to the patient, engineer, or user associated with the equipment. Materials and Methods: This is an MHE study of the iMM, also monitoring the maintenance and calibration of different equipment by technicians and engineers responsible internally and externally. Discussion and Practical Results: A maintenance software for the iMM was chosen to help the institute to have all the equipment information in a more organized way. Monitoring of some iMM equipment was conducted. Conclusion: It was found that the safety of patients, engineers, or users who manage MHE is an extremely principal factor. For this factor not to be harmed, constant monitoring, maintenance, and calibration of the equipment are necessary, ensuring the safety of the user and their proper functioning.

Design and Implementation of Medical Equipment Rational Deployment Information System Based on ASP.NET

Based on ASP.NET framework, The Intelligent Estimated System for Rational Deployment of Medical Equipment (MERDIS) is designed and developed with SQL Server 2012 database and C# language. The system is used to realize the rational deployment suggestions and evaluation of medical equipment in hospitals. The system input the data of hospital medical equipment and clinical pathway into the database, and then feedback the deployment information to users which are calculated by big data information, so as to achieve the purpose of giving rational deployment of hospital medical equipment.

Development Progress of Ventilator

Ventilator is an indispensable emergency medical equipment in hospitals. The global outbreak of the coronavirus disease 2019 (COVID-19) has highlighted the importance of the ventilator, which has attracted the attention and research on ventilators of all countries in the world. This article reviews the development history of the ventilator, briefly introduces the main air circuit structure and working principle of the ventilator, and then deeply analyzes the key technologies of this device. In addition, it compares some major brands of ventilators from several aspects in the market. Finally, the development trend and perspective of ventilators are presented.

Psychosocial care experiences of patients with COVID-19 at home in Iran: A qualitative study.

Due to the onset peak of COVID‐19, as well as a shortage of human resources, physical environment, protective and medical equipment in hospitals, many patients with mild to moderate symptoms of COVID‐19 are pushed to home care. This condition not only raises public health concerns but also causes a number of psychosocial problems. Therefore, this study intends to examine the psychosocial experiences of patients with COVID‐19 after passing the crisis stage. A qualitative study with a conventional content analysis method was used. Thirty participants were selected using purposeful sampling from Khoy Educational and Medical Centers from 20 March to 20 June 2020. In‐depth semi‐structured interviews were used to collect data. Data were analysed by continuous comparative analysis using MAXQDA 10 software. The concepts extracted from data analysis identified eight subthemes and three main themes. Social rejection theme includes three subthemes: ‘Insularity of the patient’, ‘Concealment’ and ‘patient as the life‐threatening center’. Lack of support theme consists of three subthemes including: ‘financial concerns’, ‘non‐response of the treatment team after discharge’ and ‘concerns about the persistent condition of the disease’. Efforts to gain mental peace theme has two subthemes: ‘recourse to spirituality’ and ‘strengthening hope’. According to the results of the present study, it is necessary to examine the psychological and social needs of patients. Also, by identifying high‐risk groups, supportive psychological networks such as telephone, internet and on‐site medical services to help patients, medical worker and others affected in overcoming psychological problems should be increased. Providing free service packages such as the Internet, free financial aid to damaged jobs and creating the necessary platforms for online shopping and payment services, as well as training on how to plan and practice rehabilitation at home for patients and family caregivers can be helpful.

Designing A Model of Medical Equipment Purchase Management in Hospitals of Tehran University of Medical Sciences

Objective: Medical equipment plays an effective and vital role in the diagnosis and treatment of diseases. Each society dedicates a plethora of health resources to these facilities. Since prioritizing and resource allocation are crucial in low-income countries with limited health resources, understanding and improving the purchase management of medical equipment in hospitals is a primary key for preparing high-quality health services. The aim of this study was to design a model for medical equipment purchase management at hospitals affiliated with the Tehran University of Medical Sciences. Methods: The statistical population for the present applied study, consisted of 623 people and the research sample was comprised of 420 people, which was selected using the stratified random sampling method. Data was collected using a researcher-made questionnaire whose variables were extracted from comparative studies and whose validity was measured by the relative content validity coefficient, content validity index and Cronbach's alpha coefficient. The SPSS 18 and AMOS were employed for analyses. Results: The most and the least effective aspects of medical equipment purchase management in the studied hospitals were found to be decision-making (path coefficient of 1.244) and organization respectively (path coefficient of 0. 845). Conclusion: It is crucial to take factors into consideration when using the facilities and capacities available in health and treatment centres. The proposed model can best guide buyer institutions to move towards efficient purchase mentioned in upstream policy documents.

Practical Design of Flow Meter for Mechanical Ventilation Equipment

This paper introduces a practical technique for the design of an instrument used in air flow measurement or flowmeter. This instrument is an essential component in the hospital medical ventilation equipment functioning, therefore, the parameters design presented in this article focus on this purpose. However, this instrument can be employed to any measurement scale. The technique is based on indirect flow measurement, using a sensor that converts the flow parameter into a differential pressure measurement. An electronic transducer allows the differential pressure values to be obtained as an electrical signal, which is then digitized and analyzed to obtain the original parameter. The experimental procedure presented in this paper utilizes a computational algorithm to perform the signal analysis; however, given the simplicity of the procedure, this could be adapted to any digital processing card or platform, to show the measurement obtained immediately. Preliminary analyses demonstrated instrument efficiency with sensitivity of 0.0681 L/s. Accuracy evaluation showed an average measurement error lesser than 1.4%, with a standard deviation of 0.0612 and normal distribution over the set of test measurements.

Utilization Review of Imaging Equipment: An insight into CT Scanning

Introduction: Radio diagnosis service plays a crucial role in diagnosis of the patient’s disease. The volumeof patients utilising this service is very high. This service also takes away the sizeable share of total capitalinvestment and therefore, the optimal utilization of this service becomes important.Methodology: Literature review was done through Google scholar, electronic database of PubMed andother relevant databases. The query terms like Utilization Review of Imaging Equipment, Utilisation of CTScanners, Capacity of Scanners in Radiology and Waiting Times for Imaging were used to fetch the relevantdata sources. Around 130 articles were reviewed and analysed.Results: The number of CT Scans per 1 million of population in High Income (HI), Upper Middle Income(UMI), Lower Middle Income (LMI) are 14.7, 7.3, 3.7. The CT scanners are one of the most expensivepieces of medical equipment in hospitals, with CT scanners costing between $1 million (?7 crore) and $2million (?14 crore).There is a substantial variation in the utilisation of these services, including number of scans per day andwait times. Increasing the scanner efficiency and utilisationcan significantly decrease the cost per scan andincrease access to imaging services.Expanding capacity, improving operating procedures by reducing change-over times, and improvingcapacity allocation in combination with scheduling procedures can contribute to the overall reduction of CTaccess time.Discussion and Conclusion: By acquiring Utilization data about CT Scanners, we get to know a completeand accurate overview of how Scanners are used. The CT scanner utilisation can be improved in both publicand private health sector by analysingthe key information about the utilisation of their own and other healthservices’ CT scanners.

Lean and Computerized Management System for Non-Hospital Owned Medical Equipment in Hospital

Many challenges exist in the management of non-hospital-owned medical equipment. This paper proposes implementing a novel kind of lean and computerized management method, including the management policy, procedures, agreement signing, equipment installation, acceptance and maintenance, and exit procedure. The result shows that the Lean and computerized management system can improve oversight and assure the safe integration of non-hospital-owned equipment to reduce liability exposure and increase compliance with regulations.

Analysis of Shared Services Center Deployment at a University Hospital (CENTROMED) in Natal, Brazil: A Study on Availability and Capacity.

PurposeThe hospital is an organization that has its own characteristics that differentiate it from other institutions. It is characterized as a company providing services of social purpose, with a great operational complexity, due to the diversity of services provided. These organizations are dependent on technology to play the role of assisting society. Technology is onerous: it is up to the aforementioned institutions to adopt management tools to control these costs. The present study explains the process of implementing a shared service centre (CENTROMED) for the management of hospital medical equipment (HME) at the Hospital Universitário Onofre Lopes (HUOL) in the city of Natal, RN.Patients and MethodsIn order to achieve a successful implementation, four key steps were taken: process modelling; determination of key performance indicators, organization of physical arrangement; and adequate training and development of human resources. The work followed an action research approach focusing on three main methodological steps: identification of HUOL clinical engineering team’s demands, definition of the process for providing the equipment service, and definition of the supply items that will be managed.ResultsThe preliminary results of this research indicate that the centralization of the management of the HME contributed to the optimization of the processes, the reduction of the costs and the availability of the equipment, thus providing a powerful management tool to support the hospital operational management.ConclusionThe utilization of the shared service center for the management of hospital medical equipment is ultimately linked to the patient’s well-being as it contributes to the agility in hospital procedures and provides support in maintaining the capacity of attendance of the assistance teams.

The role of medical equipment in the spread of nosocomial infections: a cross-sectional study in four tertiary public health facilities in Uganda

BackgroundWith many medical equipment in hospitals coming in direct contact with healthcare workers, patients, technicians, cleaners and sometimes care givers, it is important to pay close attention to their capacity in harboring potentially harmful pathogens. The goal of this study was to assess the role that medical equipment may potentially play in hospital acquired infections in four public health facilities in Uganda.MethodsA cross-sectional study was conducted from December 2017 to January 2018 in four public health facilities in Uganda. Each piece of equipment from the neonatal department, imaging department or operating theatre were swabbed at three distinct points: a location in contact with the patient, a location in contact with the user, and a remote location unlikely to be contacted by either the patient or the user. The swabs were analyzed for bacterial growth using standard microbiological methods. Seventeen bacterial isolates were randomly selected and tested for susceptibility/resistance to common antibiotics. The data collected analyzed in STATA version 14.ResultsA total of 192 locations on 65 equipment were swabbed, with 60.4% of these locations testing positive (116/192). Nearly nine of ten equipment (57/65) tested positive for contamination in at least one location, and two out of three equipment (67.7%) tested positive in two or more locations. Of the 116 contaminated locations 52.6% were positive for Bacillus Species, 14.7% were positive for coagulase negative staphylococcus, 12.9% (15/116) were positive for E. coli, while all other bacterial species had a pooled prevalence of 19.8%. Interestingly, 55% of the remote locations were contaminated compared to 66% of the user contacted locations and 60% of the patient contacted locations. Further, 5/17 samples were resistant to at least three of the classes of antibiotics tested including penicillin, glycylcycline, tetracycline, trimethoprim sulfamethoxazole and urinary anti-infectives.ConclusionThese results provides strong support for strengthening overall disinfection/sterilization practices around medical equipment use in public health facilities in Uganda. There’s also need for further research to make a direct link to the bacterial isolates identified and cases of infections recorded among patients in similar settings.

Dynamic Voltage Restorer (DVR): A Comprehensive Review of Topologies, Power Converters, Control Methods, and Modified Configurations

Power quality is a pressing concern and of the utmost importance for advanced and high-tech equipment in particular, whose performance relies heavily on the supply’s quality. Power quality issues like voltage sags/swells, harmonics, interruptions, etc. are defined as any deviations in current, voltage, or frequency that result in end-use equipment damage or failure. Sensitive loads like medical equipment in hospitals and health clinics, schools, prisons, etc. malfunction for the outages and interruptions, thereby causing substantial economic losses. For enhancing power quality, custom power devices (CPDs) are recommended, among which the Dynamic Voltage Restorer (DVR) is considered as the best and cost-effective solution. DVR is a power electronic-based solution to mitigate and compensate voltage sags. This paper provides a thorough discussion and comprehensive review of DVR topologies based on operations, power converters, control methods, and applications. The review compares the state-of-the-art in works of literature, and comparative study on power quality issues, the DVR principle along with its operation modes, the DVR components, the DVR topologies based on energy storage, the DVR topologies based on single-/three-phase power converters, and the DVR topologies based on control units that have different control processing stages. Furthermore, modified and improved configurations of the DVR, as well as its integration with distributed generations, are described. This work serves as a comprehensive and useful reference for those who have an interest in researching DVRs.

Epidemiology of Bacterial Contamination of Inert Hospital Surfaces and Equipment in Critical and Non-critical Care Units: A Brazilian Study

Aims: The hospital environment is an important reservoir of microorganisms, including multidrug-resistant pathogens, which can cause in-patient contamination and healthcare-related infections. The objective of this study was to describe the epidemiology of bacterial contamination (contaminated sites, pathogen species and their antimicrobial susceptibility, and identifying of multidrug-resistant microorganisms - MDR) of inert hospital surfaces and medical equipment in two public hospitals in Northern Brazil.
 Methods: This was a cross-sectional study with 243 samples (n = 208, from Hospital A; and n = 35, from Hospital B) collected by friction with humidified swabs from inert surfaces and equipment. Sequentially the samples were cultivated and bacterial species were identified by culture-based methods and tested for their susceptibility through agar diffusion assay according to the Clinical and Laboratory Standards Institute (CLSI).
 Results: Most inert surfaces and equipment analyzed presented bacterial contamination (95.5%). Staphylococcus aureus was the main pathogen of clinical significance detected both in Hospital A (61.8%) and B (68.6%). Hospital A showed higher rates of isolated MDR bacteria than Hospital B, especially in the Adult Intensive Care Unit, which included methicillin-resistant Staphylococcus aureus (MRSA) (52.7%), Enterobacteria resistant to 4th generation cephalosporins (19.4%), and multidrug-resistant Pseudomonas aeruginosa (2.8%).
 Conclusion: The failures in the control of bacterial contamination of inert surfaces and equipment in the two hospitals analyzed reinforce the need for a revised protocol for cleaning and disinfection of the inert surfaces and equipment, and for regulation of antibiotic dispensing, mainly in the AICU of Hospital A, which was found to be a reservoir of MDR pathogens.

Requerimientos funcionales para el diseño conceptual del sistema automatizado para la trazabilidad del mantenimiento equipos médicos

Currently, healthcare uses very complex medical equipment, particularly for life-support. Although medical equipment helps to improve care, it is not without risks; events can occur as a result of failures, malfunction or user error. The Department of Biomedical Engineering is responsible for the management of medical equipment in Hospitals to guarantee safety and quality in patient care; nursing is not involved in this process. This paper proposes a methodology to identify the functional requirements to design a computer system, called Nursing Medical Equipment System (NMES) to support the traceability of maintenance, training and monitoring of medical equipment; to comply with one of the fourpronged approach policy concerned to medical equipment use, issued by the World Health Organization. A survey was conducted among 24 nurses from Intensive Care Units of three hospitals, from this survey and additional information provided by the Department Biomedical Engineering, the software components were designed. The conceptual design was based on the unified modeling language methodology and a three-tier architecture (client-server model) was proposed for its implementation. NMES consists of the following modules: inventory, track work order, maintenance logbook, quick reference, and technovigilance. NMES supports nursing staff to get involved in the functioning status of medical equipment, raise awareness in the nursing staff regarding the importance of having technical support from the DBE in their daily work process, in order to contribute to the continuous improvement of care delivered to patients.

ASSISTANT MULTI-PARAMETRIC METHOD TO THE SELECTION IN THE PROCESS OF INCORPORATION OF HOSPITAL EQUIPMENT

This project aims to demonstrate a multi-parametric method of hospital technology comparison. The main goal was to develop a method to assist the clinical and hospital engineering team, in the process of acquisition and incorporation of medical-hospital equipment, to be used as a tool in the comparison stage of brand options and models of available equipment in the market. The method is composed by groups of criteria or characteristics that can be evaluate referring to the technologies to be compared. This method was applied to compare autoclaves and disinfecting machines that would be purchased to install in a Material Central and Sterilization (CME) in a hospital in the south of Brazil. As a result, it was obtained the classifications with the final scoring referring to each brand and model of technology. It also contributed significantly to assist the choice definition of the equipment, considering the hospital and technology profile, as well as the requirements and expectations of the multi-professional technical group of evaluators and users.

An analysis of Croatian political parties’ pre-election manifestos and healthcare policies

Abstract Background Before the regular 2015 Parliamentary elections in Croatia, we identified and analysed topics and comprehensiveness of health policies (HPs) included in political parties’ pre-election manifestos. After the loss of government confidence, we did a follow up before the 2016 preliminary elections. Here, we present a comparison of the 2015 and 2016 results. Methods We used the Walt-Gilson policy model for the content analysis of pre-election HPs. Five evaluators independently reviewed manifestos for HPs through four dimensions: content, actors, processes and context. HPs proposed by at least two parties were included in the final analysis and by referring to any of four dimensions for specific HP, parties scored one point (maximum of four points per HP). Results Seven out of the eight parties addressed healthcare topics in their manifestos, six discussed healthcare workforce and financing, while five discussed hospital systems, primary care, medical equipment and (re)organization of the healthcare. Parties earned 41% of all points for describing content, 28% for processes, 17% for actors and 14% for context of proposed HPs. Compared to the 2015 results, most comprehensively approached HPs changed to more focus on workforce and medical equipment. Topics of access to healthcare and people with disability earned significantly less points than in 2015. Conclusions Parties’ manifestos in both 2015 and 2016 focused on topics mostly represented in the public discourse on healthcare and daily media coverage. Financing the 2015 elections, as a consequence of a large financial restructuring effort of the hospital system at the time. Health workforce topped the 2016 elections, due to large emigration of health care professionals after legislative changes and Croatia’s accession to the EU. Parties mostly focus on the content while they less frequently address the role of processes, actors, and the context needed for successful implementation of the recommended HPs.

Supplier selection for hospital medical equipment using fuzzy multicriteria decision making approach

Medical equipment is important in the healthcare service system and plays a major role in global markets. Meanwhile, selection of suitable medical equipment supplier is also essential because medical equipment relates to the patient’s life. Moreover, there are several qualitative and quantitative evaluation factors that may be conflicting in nature while assessing optimum supplier among several alternatives. This study has objectives to discover the criteria for selection of appropriate medical equipment suppliers and to illustrate methods for selection of a suitable medical equipment supplier. The ROC (Rank Order Centroid) method was applied to determine the weight of each criterion. Fuzzy TOPSIS (Fuzzy Technique for Order Preference by Similarity to Ideal Solution) was used to select the optimal supplier. A case study was chosen concerning a hospital in the northeast of Thailand. Findings indicated the main criteria for consideration of supplier selection as quality, price, reliability, agility, compliance, service, benefits/bargaining, and transport/delivery and the results showed that out of five candidates, supplier A was the optimal choice.