Hospital Medical Equipment Research Articles

Mobile phones should not be used in clinical areas or within a metre of medical equipment in hospitals

Question Does electromagnetic radiation emitted by mobile phones cause clinically relevant interference with medical equipment used to monitor or treat patients in hospital? Study design Systematic review. Main results Seven studies met inclusion criteria. Twenty-nine categories of medical equipment were tested. Fourteen of the 457 devices tested at 1800 MHz and 45 of the 479 devices tested at 900 MHz experienced electromagnetic interference. At 900 MHz, clinically relevant interference occurred at a maximum distance between 5 cm and 200 cm depending on the device. At 1800 MHz, clinically relevant interference occurred at a maximum distance between 5 cm and 80 cm depending on the device. However, neither frequency caused consistent interference with any of the 29 categories of equipment investigated. The two largest studies reported that electromagnetic interference affected 23–53% of medical devices, and that about 10% of this interference was likely to endanger patients. Authors’ conclusions Mobile phone use should be restricted in hospitals, particularly in clinical areas and within 1 metre of medical devices.

Efficacy of Glutaraldehyde Disinfectant Against Cryptosporidium parvum in the Presence of Various Organic Soils

The opportunistic protozoan Cryptosporidium parvum is highly resistant to disinfectants, including those specifically used for processing reused medical equipment in hospitals. C. parvum oocysts were dried onto glass and steel grooved penicylinders and challenged with 2.5% glutaraldehyde solution in the presence of 3 types of soil with exposures at 10 min, 90 min, and 10 h. The influence of organic soils on disinfection was measured with 5% fetal bovine serum (FBS), 10% FBS, and 5 mg mucin/mL. An in vitro excystation procedure and cell culture infection assay were used to determine survivability of oocysts after the germicide challenge. In the presence of organic soil, all oocysts removed from carriers excysted and infected cell monolayers after all germicide contact times. However, excystation was observed only from oocysts that received no protection from organic soil after 10 h exposure. In these samples, no infection was observed in the cell monolayers. The results of this research demonstrate the importance of thorough cleaning of medical equipment before disinfection.

提言:医療機器の管理はどうあるべきか(<特集>医療機器の管理はどうあるべきか)

提言:医療機器の管理はどうあるべきか(<特集>医療機器の管理はどうあるべきか)

Electromagnetic interference on medical equipment by low-power mobile telecommunication systems

There have been a number of reports of electromagnetic interference (EMI) on electronic medical equipment caused by mobile telecommunication systems. In Japan, the use of the personal handy-phone system (PHS) has greatly expanded within urban areas, PHS handsets transmit EM signals at a frequency of 1.9 GHz and have a peak radiated power of 80 mW. This power level is lower than that of other mobile telecommunication systems. Two studies were carried out. One was to determine whether or not PHS interferes with electronic medical equipment in hospitals. We observed no EMI on electronic medical equipment when the PHS handset was in either the speaking mode or on standby. The second study was to observe EMI from 1.9-GHz signals at several radiation power levels. Although EMI was not observed at the radiated peak power of the PHS handset, EMI on some of the tested equipment was observed when the radiated power was ten or more times higher than that of the PHS handset.

Economic and ethical considerations in managed care.

The growth of managed care has had a significant impact on the way hospitals provide medical services, the relationships between hospitals and physicians, and the relationships between providers and patients. This impact arises primarily from the economic constraints that managed care places on the provider. As hospital employees or contractors, and as consumers of health care services, clinical engineering personnel need to understand the effects of managed care on the hospital and the physician. Beyond general information, this knowledge can play a useful role in understanding the impact of managed care on the acquisition and use of medical technology, and the increasing role that clinical engineering can play in guiding investment in, use and maintenance of hospital medical equipment. Ironically, this potential for increased value occurs at a time when clinical engineering services and departments themselves are under increased scrutiny for their more measurable costs and value.

Observations on health care issues in the former Soviet Union.

With the demise of the Soviet Union, the health care systems that remain in the component countries face many problems not seen in Western countries since the late 1800s or early 1900s. The author traveled to several countries of the newly independent states (NIS) of the former Soviet Union and observed problems in hospital sanitation, public health, medical equipment and supply distribution, food quality and safety, and the delivery of medical services. The author makes several suggestions to improve the delivery and quality of health care services in the NIS. His recommendations include: developing health care standards similar those that were first implemented in the U.S. by the American College of Surgeons in 1919; the use of practice guidelines and outcomes measures; building on organizational structures from the old state health system for professional and public health education; and restructuring the old delivery system to form a new delivery model based on centers of excellence and group practice managed care. Because of so many needs, the author stresses keeping reforms as simple as possible so as not to overburden the health professionals. The author also calls on Western countries, particularly the U.S., to assist with rebuilding of the health care delivery system of its Cold War adversary as it helped Germany and Japan after World War II. Such aid should be viewed as humanitarian in nature and should be distributed to private/public partnership efforts. The author says recent Congressional proposals to cut off aid in order to influence the Russian government's position on nuclear technology sales to Iran and the Chechen war are short sighted and will only hurt the citizens of these countries while having little or not impact on the leadership.

Role of bacteriological monitoring of the hospital environment and medical equipment in a Neonatal Intensive Care Unit

The aim of this study was to evaluate the usefulness of performing routine monthly bacteriological surveillance of the nursery environment, resuscitation equipment, baby placement sites, medications, formula feeds, cleansing solutions and miscellaneous medical items such as intravenous cannulae in relation to development of hospital-acquired bacteraemia in a Neonatal Intensive Care Unit (NICU) over a period of 19 months. The study is based on a retrospective review of records from the neonatal division and the microbiology laboratory. On discriminant analysis, only three NICU sites, namely baby placements, resuscitation equipment and various cleansing solutions were found to be significantly associated with hospital-acquired infections (HAI) ( P < 0·001). The probability that a batch of newly admitted babies would develop HAI if all three sites were colonized was 0·602. Similarly, the probability if none of these sites was colonized was 0·10. On multiple logistic regression analysis, however, the relative risk of infection was greatest if baby placement sites were colonized (Odds ratio = 7·48; P < 0·01). In contrast, pathogens present in the inanimate NICU environment, e.g. floors, walls, sink-drains or furniture were not associated with HAI. Routine bacteriological surveillance of the inanimate nursery environment, is not therefore justified. However, our results suggest that routine bacteriological monitoring of medical equipment and cleansing solutions may have a role in the prevention of HAI.

The state of the art and trends in the development of general hospital medical equipment

The state of the art and trends in the development of general hospital medical equipment

Evaluation of the utilization of medical equipment in hospitals.

Evaluation of the utilization of medical equipment in hospitals.