SPECIALIST ENGINEERING
An AER tray mid-commissioning test cycle.
through the RO feed pipework to each AER and the AER itself.
n During daily heat sanitisation cycles, the RO ring mains reach temperatures of up to up to 90˚C, which exceeds the maximum allowable AER supply temperature. As a result, the RO heat sanitisations have been scheduled ‘out of hours’ when the AERs are not in use.
n It is important that the RO system, distribution pipework, disinfection protocol, AERs, and water quality testing, are coordinated and scoped at the initial planning and shop drawing stage for a seamless installation.
n The design needs to consider an ‘Instrument Air’ supply to feed the AERs and drying cabinet equipment. This air is of a high purity and critical nature not generally found in existing hospital infrastructure. Drying cabinets continually force HEPA-filtered air through all endoscope channels to ensure that they are dry and fluid-free. These cabinets need to maintain a constant air supply, and a short outage can result in the requirement to reprocess all endoscopes, and cause a significant impact on service delivery.
n Carefully document pressure performance requirements, build tolerances, and inspect and test room sealing during construction for rooms required to achieve pressure gradients. This is key, as room pressures can be difficult to achieve, and leaks are challenging to detect and rectify post- construction. Particular attention is required for the sealing of medical pendants and wall panels.
n Allow adequate time for commissioning and validation (IQ, OQ, and PQ) of installed equipment. This is a significant process involving multiple steps and stakeholders, which necessitated a detailed commissioning plan to be drafted early in the process. Also, AS/NZS 4187 does not provide water quality tolerances, or advise on this aspect if specified limits are exceeded. Ensure that a procedure is in place if the water test results do not conform to the specific requirements of table 7.3. Ensure that your laboratory is NATA accredited, and able to conduct the specific tests required, for atypical Mycobacterium species.
n Endoscope monitoring equipment
Continental Water reverse osmosis plant.
requires significant data and audio- visual cabling between equipment and display monitor pendants. Early co- ordination and planning are required to ensure that cabling and connections fit through medical pendants with a sufficient bend radius. Ensure that cabling paths do not compromise envelope sealing and room pressurisation.
n Construction within an operational tertiary hospital requires a significant amount of stakeholder engagement and planning to minimise disruption, for example caused by planned power outages, vibration, noise, and dust. The endoscopy project was delivered on Level 1, with several critical and sensitive areas located in proximity. Plumbing and drainage works were required within the radiation oncology department located below, housing immunocompromised cancer patients, and linear accelerators with highly sensitive calibration settings had to be managed and checked. The Planned Procedures Centre was above, with two operating theatres – including an ophthalmology theatre and eye microscope, and ward recovery and sleeping area for inpatients. A process for managing noise, dust, water leaks, and vibration monitoring with clinical staff in surrounding departments was required throughout to successfully complete the works.
Summary Nursing staff preparing an endoscopy procedure room. 22 Health Estate Journal November 2020
The TUH endoscopy redevelopment was a complex project, which was undertaken over several years. Although at times it was a difficult journey, the project’s success is a testament to the entire project team, contractors, and stakeholder groups involved. The result is a fully functional and compliant endoscopy department supporting the Townsville HHS to deliver quality healthcare to the North Queensland region for many years to come.
hej
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