SAFETY


existing hazards should be discussed with real examples.


A medical isolation transformer


separates The OR’s network from the national grid. There is sufficient insulation monitoring with alarms within the network: l The insulation level monitoring device monitors the insulation of the floating IT network (leakage current), transformer load (current A), and temperature (°C).


l The system monitoring panel indicates any insulation level alarms, line controller alarms, test lead faults, transformer overloading, and temperature alarms.


l The line controller monitors the continuity of the floating IT network’s protective earth (P/E wire).


l The fault locator unit locates any insulation faults in the floating IT network.


It is also worth investing in usability, facilitating staff workflows, and speeding up operations with a cloud service that enables remote operation, alarm transfer, and storage with statistics. A remote monitoring station could be at the nurses’ counter or break room. Electronic devices should be used only in sockets intended for them, and


markings should be clearly made. Electric cables should be arranged safely, and no unnecessary wires or other items should be on the floor. We have noticed a current trend for


the entire medical IT system to be installed in the OR. It would be wise to consider possible malfunctions and maintenance; would it make sense to keep some of the equipment elsewhere so that a malfunction/maintenance does not interrupt surgery when technical staff have to come to the operating room? A technical cabinet in the hallway could be a good solution for electrical maintenance. This avoids cleanroom problems, and there are no costly downtimes. Electrical Services are informed immediately, the faulty device is quickly replaced, and the defective device goes for maintenance.


Summary We are now at the point where global safety measures are being developed due to constantly increasing awareness and prioritisation of patient safety, so international legislation is being implemented in different countries to meet the current requirements. Implementation should also be


controlled, and sanctions for neglect should be determined. In addition to


saving human lives, operating room outages will decrease, leading to efficiency and cost reductions. Before these critical premises are used, the authorities should, during their commissioning inspections, pay special attention to ensuring that all electrical installations are in accordant with laws, regulations and standards and that Group 2 medical facilities have performed power and equipotential measurements. In Finland, the commissioning inspection is always carried out before a new installation is implemented or additions or changes are made to an existing building. Maintenance is a topic that needs far


more attention and detailed discussion. If this single issue is handled correctly, it will resolve many problems in healthcare industries.


Electricity can be an utterly invisible killer that may not even leave a trace. It is possible to prepare for these hazards with advanced safety equipment and adequate training. The cost is minimal in comparison to the benefit; the lifecycle of an insulation monitoring system can be over 30 years.


IFHE


l The author would like to thank Mr Ranjit D Deshmukh (India), Mr Mohd Farez (Malaysia) and Mr Gary Mcilvain (UK) for their country- specific reviews.


IFHE DIGEST 2024


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