Documentos de Académico
Documentos de Profesional
Documentos de Cultura
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https://www.tandfonline.com/doi/pdf/10.1586/17434440.4.6.759
Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic
development
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Implementing an oxygen programme in hospitals in Papua New Guinea
Habla de una implementación de un sistema deoxigeno para un hospital….
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Clinical engineering departments in hospitals are responsible for establishing and regulating a
Medical Equipment Management Program to ensure that medical devices are safe and reliable. In
order to mitigate functional failures, significant and critical devices should be identified and
prioritized. In this paper, we present a multi-criteria decision-making model to prioritize medical
devices according to their criticality. Devices with lower criticality scores can be assigned a lower
priority in a maintenance management program. However, those with higher scores should be
investigated in detail to find the reasons for their higher criticality, and appropriate actions, such
Clinical engineering departments in hospitals are responsible for establishing and regulating a
Medical Equipment Management Program to ensure that medical devices are safe and reliable. In
order to mitigate functional failures, significant and critical devices should be identified and
prioritized. In this paper, we present a multi-criteria decision-making model to prioritize medical
devices according to their criticality. Devices with lower criticality scores can be assigned a lower
priority in a maintenance management program. However, those with higher scores should be
investigated in detail to find the reasons for their higher criticality, and appropriate actions, such
as ‘preventive maintenance’, ‘user training’, ‘redesigning the device’, etc, should be taken. In this
paper,we also describe how individual score values obtained for each criterion can be used to
establish guidelines for appropriate maintenance strategies for different classes of devices. The
information of 26 different medical devices is extracted from a hospital's maintenance
management system to illustrate an application of the proposed model. as ‘preventive
maintenance’, ‘user training’, ‘redesigning the device’, etc, should be taken. In this paper,we also
describe how individual score values obtained for each criterion can be used to establish
guidelines for appropriate maintenance strategies for different classes of devices. The information
of 26 different medical devices is extracted from a hospital's maintenance management system to
illustrate an application of the proposed model.
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A comprehensive fuzzy risk-based maintenance framework for prioritization of medical
devices
Medical equipment such as infant incubator, infusion pump, CT scanner, etc. should be maintained
properly to meet adequate standards of reliability in healthcare services. This paper proposes a
new comprehensive risk-based prioritization framework for selecting the best maintenance
strategy. The framework encompasses three steps. In the first step, a fuzzy failure modes and
effects analysis (FFMEA) method is applied by considering several risk assessment factors. In the
second step, seven miscellaneous dimensions such as use-related hazards, age, and utilization are
applied to consider all aspects of hazards and risks in prioritization of medical devices. Finally, a
simple method is introduced in the third step in order to find the most suitable maintenance
strategy for each device according to the scores produced by the previous steps. A numerical
example illustrates the proposed approach and shows that, through the method introduced in this
paper, managers can easily classify medical devices for maintenance activities according to their
criticality scores. Implementation of this framework could increase the availability of high risk
machines in healthcare industries. Moreover, this framework can be applied in other critical
industries such as aviation by modifying some criteria and dimensions.
El equipo médico, como la incubadora de bebés, la bomba de infusión, el
escáner de tomografía computarizada, etc., debe mantenerse adecuadamente
para cumplir con los estándares adecuados de confiabilidad en los
servicios de atención médica. Este documento propone un nuevo marco
integral de priorización basado en riesgos para seleccionar la mejor
estrategia de mantenimiento. El marco comprende tres pasos. En el primer
paso, se aplica un método de análisis difuso de modos y efectos de falla
(FFMEA) considerando varios factores de evaluación de riesgos. En el
segundo paso, se aplican siete dimensiones diversas, como los peligros
relacionados con el uso, la edad y la utilización, para considerar todos
los aspectos de los peligros y riesgos en la priorización de los
dispositivos médicos. Finalmente, se introduce un método sencillo en el
tercer paso con el fin de encontrar la estrategia de mantenimiento más
adecuada para cada dispositivo de acuerdo con las puntuaciones producidas
por los pasos anteriores. Un ejemplo numérico ilustra el enfoque
propuesto y muestra que, a través del método presentado en este
documento, los gerentes pueden clasificar fácilmente los dispositivos
médicos para las actividades de mantenimiento de acuerdo con sus puntajes
de criticidad. La implementación de este marco podría aumentar la
disponibilidad de máquinas de alto riesgo en las industrias de la salud.
Además, este marco se puede aplicar en otras industrias críticas como la
aviación modificando algunos criterios y dimensiones.
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Abstract
Purpose
The purpose of this paper is to review maintenance strategies within the healthcare domain
and to discuss practical needs as gaps between research and practice.
Design/methodology/approach
Findings
This study highlights the significant issues relevant to the application of dependability
analysis in healthcare maintenance, including the quantitative and qualitative criteria taken
into account, data collection techniques and applied approaches to find the solution. Within
each category, the gaps and further research needs have been discussed with respect to both
an academic and industrial perspective.
Practical implications
It is worth mentioning that medical devices are becoming more and more numerous,
various and complex. Although, they are often affected by environmental disturbances,
sharp technological development, stochastic and uncertain nature of operations and
degradation and the integrity and interoperability of the supportability system, the
associated practices related to asset management and maintenance in healthcare are still
lacking. Therefore, the literature review of applied based research on maintenance subject
is necessary to reveal the holistic issues and interrelationships of what has been published
as categorized specific topics.
Originality/value
The paper presents a comprehensive review that will be useful to understand the
maintenance problem and solution space within the healthcare conte
Resumen
Propósito
Cabe mencionar que los dispositivos médicos son cada vez más numerosos,
variados y complejos. Aunque a menudo se ven afectados por perturbaciones
ambientales, un fuerte desarrollo tecnológico, la naturaleza estocástica
e incierta de las operaciones y la degradación y la integridad e
interoperabilidad del sistema de compatibilidad, aún faltan las prácticas
asociadas relacionadas con la gestión y el mantenimiento de activos en la
atención médica. Por lo tanto, la revisión de la literatura de
investigación aplicada basada en temas de mantenimiento es necesaria para
revelar los problemas holísticos y las interrelaciones de lo que se ha
publicado como temas específicos categorizados.
Originalidad / valor
El documento presenta una revisión integral que será útil para comprender
el problema de mantenimiento y el espacio de solución dentro del contexto
de la atención médica.
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Criticality Analysis of Medical Equipment: A Case Study at King Hussein Cancer Center
(KHCC) Amman-Jordan
Proper maintenance management of medical equipment is of prime importance to the health
sector as otherwise this would result in poor treatment, longer waiting times and patients
suffering as well as draining, the normally limited, financial resources of most public medical
institutions. King Hussein Cancer Center (KHCC), Amman-Jordan is a unique medical institution
where treatment of different types of cancer is provided and where equipment unavailability is
considered a risky event which may result in life-threatening complications. This is especially true
for critical treatment equipment. Criticality analysis was performed on a representative sample of
medical equipment at KHCC in order to assess and improve the effectiveness of current
maintenance management policy. A sample of twenty-one medical devices was selected for this
study. Past failure and maintenance data, in addition to relevant financial information, were
collected for these devices and compiled into criticality ranks. In order to take account of the
special nature of these equipment medical criticality (in terms of risk score) values were also
calculated based on relevant tables of the American Society for Healthcare Engineering (ASHE).
Overall criticality ranking of medical equipment was then determined based on equipment cost,
ASHE risk score, reliability and maintenance cost. The present results have revealed major flaws
within the purchase and maintenance policies at KHCC. For example, some extremely expensive
devices with extremely high-cost maintenance contracts were revealed to exhibit low reliability
values and suffer from repeated failures. These were within patient-sensitive equipment cancer
treatment devices. The results also have shown that under "less than optimum" maintenance
practice, the ASHE risk score may be a misleading measure of equipment criticality. This was
shown by comparing the obtained overall equipment criticality to their ASHE risk score where high
level of discrepancy was present between the two measures.
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Infection Control and the Prevention of Nosocomial Infections in the Intensive Care Unit
Nosocomial infections continue to be significant causes of morbidity, mortality, and added costs in
the health care setting. Half of all life-threatening nosocomial bloodstream infections and
pneumonias occur in intensive care units (ICUs), despite ICUs representing only 15 to 20% of all
hospital beds. Thus an efficient focus for prevention and control of life-threatening health care-
associated infections should be in ICUs. Further, growing antibiotic resistance complicates the
therapy of serious infections. Meticulous infection control practice with continued attention to
hand hygiene is of paramount importance. Strict adherence to evidence-based catheter insertion
and maintenance policies reduces nosocomial bloodstream infections. Evidence-based prevention
strategies for ventilator-associated pneumonia, including management of respiratory equipment
according to published guidelines and maintaining backrest elevation at 30 to 45 degrees, are
effective. For greatest risk reduction, multifaceted programs ensuring maximal adherence with
evidence-based infection control guidelines are needed.
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Occurrence of hepatitis B and C infection among hemodialyzed patients with chronic renal
failure in Qazvin, Iran: A preliminary study