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PubMed1977

Clinical engineering: an in-depth review of its economic potential.

Clinical Engineers are currently employed in hospitals to see that the more complex instrumentation is electrically safe and well maintained. Such an objective fails to capitalize on the economic advantages which can be derived from specialist management. This paper proposes that the objective be broadened to cover the application of engineering technology for lower cost-higher quality health care. The functions involved and the staff needed to attain this objective are analyzed, together with the modus operandi for selecting and integrating cost-effective equipment, designing practical maintenance programs, and training the staff to avoid equipment abuse. Details of recent equipment-oriented malpractice suits are reviewed to identify already proven vulnerable areas. The results achieved from this approach at a 450-bed University Hospital show an estimated reduction of from $144 to $59 for the average cost of a repair, and an overall 60 per cent cost saving in the handling of the biomedical electronic equipment.

Biomedical Engineering↗
PubMed1964

SURVEY ON PREVACUUM HIGH-PRESSURE STEAM STERILIZERS.

None of the 10 prevacuum high-pressure sterilizers of different makes tested was able to produce and maintain the conditions advocated by the Medical Research Council working party on high-pressure steam sterilizers (1959) or by Knox and Penikett (1958) with the result that steam did not penetrate adequately the single challenge load and it was not sterilized. The sterilization of ;group drums' of various sizes and contents was erratic and tended to give operators a false sense of security. An alarming number of minor engineering faults were present in seven out of 10 machines tested and they require very much more skilled maintenance than is being given at the moment. The possibility of centralizing sterilizers to central sterile supply departments and placing them under the care of a regional engineer cannot be too highly recommended. The presence of undetected ;leaks' and a failure to draw a prevacuum of 20 mm. even with a steam burst interferes with sterilization of a challenge load. A leak test should be performed twice daily and should not exceed more than 1 mm. in one minute at 20 mm. absolute. The centre of the load should be monitored by crossed tapes or Brownes tubes in each sterilizing cycle. Although the challenge load was sterilized when the chamber was filled to capacity, a more reliable cycle consisting of a double prevacuum of 20 mm. or more with intermediate steam burst to 10 lb. ensured the sterilizing of a single challenge load, which could be adequately controlled by the chamber drain temperature.

Engineering↗
PubMedDate not supplied

Clinical engineering in Brazil: current status.

It is estimated that 20-40% of all existing healthcare equipment in Brazil is not working because of a lack of service, parts, or supplies, or because it has not been installed. Traditionally, equipment goes completely unattended until a complete failure occurs. Then, it sits idle, paralyzing those services provided by it, until its owner gathers enough money to afford the extravagant repairs provided by manufacturers and their representatives, with little continuing assurance of quality and efficacy. During the last 10 years, a few medical institutions have started to establish their own clinical engineering (CE) teams. Besides providing significant savings, these pioneers are contributing to the improvement of the process of managing the introduction of technology into healthcare. Now, about 10% of all hospitals with more than 150 beds have their own CE departments. Three years ago, the Brazilian Association of Hospital Engineering and Maintenance was created to promote the recognition of CE as a new profession. The main difficulties that inhibit the faster and wider adoption of the self-reliant approach are analyzed and some possible solutions are discussed.

Biomedical Engineering↗