Medical equipment repair
The importance of medical equipment in the life care plan has always been a function of the physical impairment of the individual client . The greater ones physical impairments, the more dependent he or she will be on medical equipment and other assistive technology .
Medical equipment has parameters different from other factors of a life care plan . In almost all cases of permanent disability, if there is a need for certain medical equipment at the start of the plan, that expense will continue throughout the clients life expectancy . Medical equipment choices are a very dynamic function of a life care plan as well . Allowances must be made for changes in the type of equipment that will be needed . Some of these changes in equipment will be due to the ageing of a client, while others from expected physical deterioration of the client . A good example of the latter is the overuse syndrome that becomes common in spinal cord injury clients after years of propelling a manual wheelchair .
Allowances must also be made for the repair and eventual replacement of each piece of equipment . Maintenance and replacement schedules vary for different types of equipment, and factors such as manufacturers warranty, daily expected usage, and a clients environment will all play a part in assessing these variables.
Medical equipment is only one area of assistive technology that should be considered for an individual client . According to the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (Tech Act), an assistive technology device is any item, piece of equipment, or product system, whether acquired commercially, off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities . Other areas of assistive technology, such as augmentative an assistive communication systems, environmental control units, computer interface technology, and visual impairment technology may also be needed and considered for the client .
MEDICAL EQUIPMENT Factors in choosing:
The predominant factor in choosing the correct medical equipment will be the clients diagnosis and overall medical assessment . A chronic lumbar sprain requires little in the area of assistive technology, whereas a spinal cord injury resulting in some level of paralysis may require considerable equipment depending on the extent of the injury. The need for equipment is somewhat commensurate with the level of the spinal cord injury . The higher the overall break in the neurological pathway, the more severe the clients physical involvement ; consequently, there will be greater reliance on assistive technology to solve mobility, activities of daily liming, and other day-to-day independent functions .
Another factor in equipment needs is the age of the client . Equipment will change as an individual ages, not only due to physical deterioration, but also as an individuals lifestyle changes. The 4-year-old born with cerebral palsy may start childhood using a therapeutic stroller for mobility, grow into a pediatric tilt-in-space manual wheelchair, and then through increased function, graduate into a motorized wheelchair .
This also leads to another factor in determining correct equipment . With regard to the mobility needs for a particular client, whether he is able to manually propel a manual wheelchair, or is powered mobility going to be the primary option for independence . If an attendant must push the client, it must be seen whether a standard wheelchair frame meets his needs, or will he require something more specialized, such as a reclining or tilt-in-space wheelchair frame.
Often overlooked factors in determining the correct choice in equipment are the environment and lifestyle of an individual client. The equipment required for a T2 paraplegic who is living independently in a rural or urban environment, and has a full-time vocation, will be vastly different than that for a client with the same level of injury who resides in a skilled nursing facility with no occupation . Environment and lifestyle must also be considered when estimating correct replacement schedules for a clients wheelchair.
RISK MANAGEMENT :
Risk management is the implication that the hospital environment cannot be made risk-free . In fact, the nature of medical equipment to invasively or noninvasively perform diagnostic, therapeutic, corrective or monitoring intervention on behalf of the patient implies that risk is present . Therefore, a standard of acceptable risk must be established that defines manageable risk in a real-time economic environment .
Unfortunately, a preexistent, quantitative standard does not exist in terms of, for instance, mean time before failure (MTBF), number of repairs or repair redos per equipment item, or cost of maintenance that provides a universal yardstick for risk management of medical equipment . Sufficient clinical management of risk must be in place that can utilize safeguards, preventive maintenance, and failure analysis information to minimize the occurrence of injury or death to patient or employee or property damage . Therefore, a process must be put in place that will permit analysis of information and modification of the preceding factors to continuously move the medical equipment program to a more stable level of manageable risk.
Risk factors that require management can be illustrated by the example of the double-edged sword concept of technology. The front edge of the sword represents the cutting edge of technology and its beneficial characteristics :"> increased quality, greater availability of technology, timeliness of test results and treatment, and so on . The back edge of the sword represents those liabilities that must be addressed to effectively manage risk : the hidden costs, our dependence on technology, incompatibility of equipment and so on .
The purchase and installation of a major medical equipment item may only represent 20% of the lifetime cost of the equipment . If the operational budget of a nursing floor does not include the other 80% of the equipment costs, the budget constraints may require cutbacks where they appear to minimally affect direct patient care. Preventive maintenance, software upgrades that address glitches, or overhaul requirements, may be seen as unaffordable luxuries. Gradual equipment deterioration without maintenance may bring the safety level below an acceptable level of management risk . written by N Swarna Lakshmi13/11/2007
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