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Care of instruments and equipment: a success story عرض

منذ 10 أشهر عقارات للبيع مكة   96 الآراء

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The nasal instruments and equipment used in modern eye care have become very sophisticated and expensive. Keeping them in good working condition can become a nightmare, especially if hospitals are located in places where there is little service support from manufacturers or suppliers. These items can fail to work unexpectedly and the resultant downtime can compromise outcomes and patient safety.

An important fact about instruments and equipment is that, when manufactured by well-established firms and supplied by reliable dealers, they seldom fail, provided they are maintained as described in the user manual.

A machine is more likely to fail when it is first set up, often due to shortcomings in its installation, use, or handling. For this reason, most manufacturers usually offer a free warranty contract for the first year. Machines should be used often during that period; any malfunction, however trivial, should be brought to the attention of the supplier and rectified immediately. If this is done, the machine will usually work well for the rest of its lifespan.

It is generally believed that doctors and/ or paramedical staff who use an instrument or machine will take care of it, but this cannot always be expected. The patient is the primary concern of doctors or paramedical staff. If there is a conflict, patient care will take precedence – so nasal suction forceps care is bound to suffer. Also, some equipment is too complex to maintain for a person who is not technically trained.

At Aravind Eye Hospital, we took these factors into account and devised a scheme whereby a technically trained person is responsible for a sophisticated pediatric nasal instrument or piece of equipment. This person's responsibility is to take care of it: to turn it on or off, and to go meticulously through all the stipulated steps before it is ready to be handed over for use by doctors and paramedical staff. This considerably lightens the workload of doctors – they can devote their full attention to the procedure and the patient. When a procedure is over, doctors and paramedical staff may be tired. Shutting the machine off in the sequence suggested by the manufacturer is then the responsibility of the technically trained person.


It is difficult to train many people within an organisation to look after sophisticated nasal opertion forceps and equipment. Not all will have the competence or the aptitude required to understand the technical details. Training one or two persons with the right aptitude and making them responsible for looking after instruments and equipment will ensure better maintenance and performance in the long term.

The complexity of medical devices has increased over the past 10 years, and outbreaks of infections due to contaminated devices have focused attention on the need to adequately clean medical devices in order to ensure the adequacy of disinfection and sterilization. There has been a paradigm shift in reprocessing of medical devices, with increased emphasis on a quality management systems approach that requires validated cleaning instructions from manufacturers and ongoing monitoring by reprocessing personnel to ensure adequacy of cleaning. This article reviews the current issues related to medical device reprocessing and summarizes the approaches used for monitoring cleaning efficacy for surgical instruments and flexible endoscope system&accessory.


 
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