Hospital Equipment Preventive Maintenance

Part of the job of the Biomedical or Clinical Engineering Department is preventive maintenance on equipment. There is a debate among some biomedical technicians that the PM’s we do are unnecessary and have no value to the equipment. It is true that many time I have completed a PM on a piece of equipment only to get a call from the nursing staff that it’s broken a few hours later. One might say that the PM was done incorrectly then. When the defective equipment is examined it is usually determined that something completely outside the realm of the PM failed in the machine.

How can you test for quality though? An IV pump may deliver the exact amount at the specified flow rate and occlusion pressures during testing and pass the PM. Remember that the pump mechanism is a mechanical device subject to wear and therefore failure, if you have ever had an engine problem on your car strand you somewhere then you can understand. You drive to the grocery store, and then drive to the dry cleaners, and then pick up the kids for soccer practice, and then stop at the pharmacy and when you come back out your car won’t start because something in the engine failed. Yet you made all of those stops and starts in your car not to mention driving it for maybe years without trouble. If you happen to live in a state as I do where they still require annual vehicle inspection it makes you wonder why the inspection didn’t catch the failing engine component. The answer is because it was not part of the inspection.

Even if we disassembled the IV pump and looked at the mechanism it is still impossible to know if it will fail soon. So the question is: Why do we bother with PM’s? We just tested it and put a sticker on the side saying it is OK to use and the nurse is standing there saying it’s broken. This kind of makes us look silly don’t you think? I believe that some PM’s are not useful at all. Thermometers, hand held pulse oximeters, laboratory centrifuges, and several other things either work or they don’t. I can’t begin to imagine how much rubber I have worn off my shoes looking for these things too. Some biomedical departments have started adopting a policy of no PM’s on anything less than life critical equipment.

Life critical equipment is things like ventilators, anesthesia machines, defibrillators, and electrosurgical units to name a few. This type of equipment should get regular checkups because it is directly used to sustain life or alter the human anatomy. But how many people do you know died because the thermometer used on them gave the wrong temperature reading? Anyone that works as a biomedical technician knows that the job can be very stressful at times. Broken equipment seems to come in waves. It’s difficult at times to juggle repairs with requests for information from different departments without having to worry about where Nurse Nancy hid her thermometer so you can do a PM on it. Which is basically nothing more than sticking the probe in your mouth to see if you get a temperature close to normal body temperature, unless you’re lucky enough to have a calibration key for it, which by the way does not calibrate it. The calibration key simply verifies that the default temperature set at the factory and programmed into a microchip is still the same.

I know there will be a few people reading this saying without PM’s I am not a necessary employee and could be let go. We were hired for our knowledge of electronics, troubleshooting skills and customer service abilities. When something breaks that is when we shine the brightest. PM’s normally go completely under the radar of most hospital staff. Let something break though and we become the most needed people in the hospital. Nurses and doctors can’t do their job with broken equipment.