BIOMEDICAL ENGINEERING
These images will be recognisable to most ‘biomeds’.
statutory requirements. It also requires ensuring that there is adequate service back-up, and that the cost of ownership has been considered.
I once had to tell a client that its $2000 defibrillator required a $700 battery. Needless to say, my client now wishes it had purchased a different brand of defibrillator. If it had asked a biomed like me what I thought prior to purchase, I would have been happy to point it in the right direction. This is just one small example of where a customer was not aware of the true cost of ownership; I have been involved in far more expensive and serious issues, where our advice was ignored, and consequently our healthcare system has suffered.
Standardising on equipment Involving biomeds in equipment purchasing also leads to hospitals standardising on equipment. Multiple monitoring systems result in the need for additional training to be given to clinicians, and, of course, a greater range of consumables must be stocked to suit each brand. Ultimately, clinical engineering involvement can prevent the hospital from purchasing junk. The costs involved with servicing healthcare equipment are massive, and biomeds have the potential to make or break a hospital’s budget.
Interconnectivity with IS In most hospitals, computer networking services are separated from clinical engineering, but the demarcation lines are starting to get fuzzier. We are now in a situation where we have increased software support versus hardware support. Consequently, my hospital has been upskilling biomeds in the area of computing networking. Biomeds are more frequently required to work with a hospital’s IT staff, as an increasing amount of equipment is becoming interconnected to the hospital’s data network. There is huge growth in this area at the moment, and we are seeing more and more equipment that requires networking, or that can enhance patient care by being connected to the hospital’s network. Here are just three examples of where biomeds are working closely with Information Services, as they are known in our hospital: n We have intravenous fluid pumps at our hospital that have Wi-Fi built in or Wi-Fi
26 Health Estate Journal August 2020
Many hospital biomedical engineers will have found a piece of equipment that they have never seen before, minus manuals and statutory paperwork, and, in the odd case, with power cables fitted with the wrong country’s plug.
tags attached to them, and thus we can use software to track the pumps’ whereabouts within the hospital. In my hospital, pumps that are used in our Emergency Department travel all over our main campus, and sometimes even to other hospitals. Using Wi-Fi, we can find these pumps wherever they are within our hospital Wi-Fi system, and this has resulted in huge savings in man-hours looking for pumps when our Emergency Department has run out of them. This has been a huge help to those involved in running ED. The same system also enables us to remotely monitor drug fridge temperatures using the same tags. If a remote temperature gauge located inside a fridge goes out of range, an alert is raised in our telephone office, and the telephone operators will call the department involved to inform them. This has resulted in the prevention of thousands of dollars’ worth of drugs being damaged.
n Our newest automated external defibrillator, the Lifepak CR2, is a Wi-Fi- connected device capable of not only sending email alerts when it is not in a ready state, but also of providing first responders with real-time ECG data remotely. For example, our ED staff can be observing a patient’s arrhythmia tracing while the patient is receiving CPR at a remote location, such as a rural hospital or medical centre, and as a biomed, I regularly receive notifications when a defibrillator has been used, and not immediately returned to a state of readiness.
n Electrocardiography machines taken on mobile ECG carts are now being automatically uploaded to the patient’s electronic medical records. Our newest monitors, such as the Welch Allyn CSM and CVSM, are capable of transmitting basic patient vital signs, such as heart rate, blood pressure, and temperature, directly to the medical network and the patient’s electronic medical records. This removes the need for the nurse to manually enter data into a PC or ‘notebook’ PC, and hence reduces the opportunity for errors, while freeing up the nurse’s time.
Ongoing in-service
improvements and education Alarm fatigue has been a hot topic for some time, and has been highlighted for several years as one of ECRI’s top 10 healthcare hazards. In my own hospital, with clinical consultation, I have been involved in helping to make the ED a quieter place to work, by altering alarm protocols. This is just one example of where I, as a biomed, have been able to make ongoing improvements to the equipment that we manage.
Welch Allyn CSM and CVSM vital signs monitors.
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