In this installment of the monthly roundtable feature article, experts from throughout the healthcare technology management (HTM) industry share insights and tips regarding IV pumps.
The panel of insiders participating in the roundtable discussion are Atlantic Biomedical’s Richard Broseker, Elite Biomedical Solutions BMET III Michael Carroll, Avante Patient Monitoring’s Lead Technician for Infusion Pumps Dorian Davis, MultiMedical Systems LLC Regional Service Manager Jose Jimenez, Infusion Pump Repair Corporation President and CEO Hassan Serhan and AIV Inc. Vice President of Sales and Product Development Jeff Taltavull.
Broseker: One thing every HTM professional should know is not all IV pumps are the same. They all may be designed to do the same thing, but they are different. Don’t go into a repair on a new IV pump that you’ve not seen before expecting them to be the same as one you’re familiar with.
Carroll: IV pumps have the ability to deliver small and large volumes accurately, as well as deliver at automated intervals, provided the pumps are maintained according to OEM requirements.
Davis: IV pumps are a critical part of patient care and play an important role in a patient’s treatment. But pumps use a lot of moving parts, which will wear down over time, similar to brake pads on your car. Maintaining your pump is a necessity.
Jimenez: The staff using the pump should know what type of cleaning solution to use on their infusion pumps (and other devices). Depending on the infusion pump, the solutions that can be used varies greatly. Using the wrong solution can dry out the plastic, causing cracks and/or hinges on the door causing flow rate issues. If the pump is accidentally dropped during transport, it should be sent back to clinical engineering so they can inspect the internals and/or verify the calibration. Even if the pump does not look physically damaged on the outside, it could be cracked internally. If the inside of the pump is cracked, it will cause the pressure and rate accuracy to be off and even make it to where it will not be able to calibrate properly.
Serhan: When the pandemic started last year in March, all the media attention was directed toward ventilators and their necessity to save COVID-19 patients’ lives. What the media missed, and what most people weren’t aware of, is that second in line after ventilators were the infusion pumps. All hospitals in the country purchased and stocked as many IV pumps as they could find or afford regardless of the immediate need. IV pumps are common and vital in every clinical setting such as hospitals, medical centers and homecare facilities. Therefore, every HTM professional should know how to maintain and perform preventive maintenance (PM) and calibration for the IV pump models used at the hospital where they work.
Taltavull: They have options when it comes to servicing. There are third-party services that offer great alternatives to the OEM. I suggest researching to ensure those partners meet the quality standards for your facility. High-quality, ISO-certified partners can provide parts and services to help reduce costs of maintenance and repairs. If a company is ISO certified, they should have a strong quality policy and traceability on all products that come in and out of their facilities.
Broseker: Some IV pumps have small pieces that can easily break. Taking it slow when opening a device is a good way to insure you won’t break things. The last thing you want to do is add more problems to a device by mishandling it.
Carroll: Perform regular maintenance and replace worn parts as needed, do not wait until there is a major failure with the device to have it serviced. It is also important not to overlook cosmetic damage like a cracked case, which could allow for fluid intrusion causing major internal damage. This could have been prevented if the case had been replaced.
Davis: Use refurbished or aftermarket parts when possible. The cost of parts has increased a lot during the pandemic. Using alternative and certified sources for parts could save you hundreds to thousands of dollars.
Jimenez: Proper cleaning and calibrations are critical. The micro-adjustments to flow and occlusion can keep the unit running until repairs are needed. Proper training for the medical staff can also help. Replacing batteries on a timely basis (every two years is recommended) prevents excess battery acid buildup.
Serhan: There are multiple easy and simple tips that can help extend the life of IV pumps and prevent them from breaking down frequently.
Taltavull: Stay in front of problems and make sure all your equipment is following recommended PM schedules. Little things like changing out your power cords regularly and keeping pumps plugged in and charged when not in use can have a big impact.
Broseker: COVID-19 has put a strain on the repair of some IV pumps. There has been a much greater demand for IV pumps. This means they are being used more frequently, and this has made it harder to access pumps when they are defective, as some are in COVID designated areas.
Carroll: COVID-19 caused a widespread demand for IV pumps. This forced otherwise unrepairable pumps, pumps that had been put aside or damaged, to ultimately be repaired. We have had the privilege to come alongside and help with this demand through new parts, rentals and repair services.
Davis: The COVID-19 pandemic has been a rough time for people across the world and has had many adverse effects over multiple aspects of our daily lives and the lives of our loved ones. One of the more severe effects it has had is the increased hospitalizations of people. Many facilities reached maximum capacity and needed more equipment to facilitate the influx of patients needing care. Infusion pumps have played an important role during this time. These devices are used to feed nutrients, medications and other fluids – more patients means more use and, subsequently, more maintenance. Since the pandemic hit, we have seen a major increase in the number of devices being ordered and needing maintenance. Infusion/syringe pumps have more mechanical parts and can start to lose performance with wear and tear. Fortunately, we planned ahead and were able to prepare for the maintenance. These devices also have built in alarm settings that help notify the users of potential errors and most are caught without putting the patient at risk.
Jimenez: Getting access to the equipment has been the most difficult piece of the puzzle for most health care providers. We have also seen a high demand for Alaris 8100 pump repairs, mainly due to the bezels cracking and transducers failing from excessive use. One of the biggest problems we had was getting a hold of replacement parts, especially from the OEM. Our biggest savior during the height of the pandemic was that many third-party manufacturers were able to provide replacement parts that are OEM approved. It would take us days to get parts from third-party suppliers when the OEM would take months due to shortages.
Serhan: We took extra precautions while servicing IV pumps during the pandemic. Most of the pumps coming from hospitals were used on COVID-19 patients. Therefore, we started disinfecting the pumps before repairing them to make sure the surface was clean from viruses. We also purchased and stocked up on replacement parts in order to accelerate the repair turnaround time.
Taltavull: Unfortunately, COVID-19 has set everyone back. In a state of crisis hospitals have been forced to use whatever they had available to save lives. This has meant pulling equipment out of retirement and in many cases disregarding maintenance. We have seen an onslaught of equipment that we haven’t seen in years. But, like everyone else, we have been finding solutions to do our part to help everyone continue to battle the front line.
Broseker: Preventative maintenance is highly important for all devices. Routine checks on a device’s functionality and minor repairs to keep a device in service could be the reason why a patient lives or dies. A device can fail during a surgery for an issue that could have easily been caught during a PM.
Carroll: PMs are very important. The PM procedure allows technicians to verify the device, being hooked up to a patient, is performing within the OEM specs. During the PM is also when we can notice an error code or physical damage and fix the issue.
Davis: Preventive maintenance is a critical component in the care of your infusion pump or any medical devices for that manner. The PM procedure is often outlined in the manufacturer’s service manual and is designed to notify the BMET or individual performing the test of any issues currently present and of issues on the way. These should be performed annually or semi-annually and daily on life-saving equipment on the floor, such as a Heartstart MRX. Even if the pump has not exhibited any failures or error, it is wise to have the device on a scheduled maintenance cycle that includes the PM being performed. After we complete our repairs in house, we will then follow up with the PM in order to recheck our work and make sure we didn’t miss anything. In some cases, the PM can also be used to troubleshoot devices and help the technician get to an issue sooner.
Jimenez: PMs are to prevent issues or address something that may become an issue before it arises. By completing PMs with a set cycle and recording the outputs for flow and occlusion pressure values it is possible to predict what parts will fail. Parts can be ordered in advance to reduce downtime. This is critical for repairs to get completed in a timely manner.
Serhan: Preventive maintenance is very important and crucial for IV pumps for many reasons. PMs have to be done routinely (at least once a year) in order to help prolong the life of the pump. Performing Ps helps with checking the battery life inside the unit and replacing it if necessary. Third, it keeps the pump’s specs in check where the accuracy rate and occlusion pressures are tested to make sure they fall within the OEM specified ranges. If PMs fail, then calibrate the pump or perform the necessary repair.
Taltavull: Again, preventive maintenance is crucial in controlling costs on infusion equipment. Keeping pumps on a routine maintenance schedule keeps the little problems from becoming big ones. It’s also crucial in these times of extremely high usage to make sure products are staying within their delivery tolerances.
Broseker: I would say taking things slow is good advice when servicing IV pumps. Working too quickly you can miss things or have trouble calibrating a device. Having to take apart a device to tweak one potentiometer after having it all closed up is never fun.
Carroll: It is important to maintain proper PM procedures and stick to OEM guidelines/specs. Another important item for servicing equipment is making sure the test equipment you are using has been calibrated as well, scales, pressure meters, etc.
Davis: Purchase the right pump for your needs and facility. Some pumps are better suited for certain types of treatment and infusions. Some pumps are large and others small, so the size of your facility may play a factor. Care providers may want to consider maintenance costs as well as availability of parts. Generally, the more used a pump is the more available parts are, though there may be exceptions to this rule.
Jimenez: When was the battery last replaced? These are recommended to be replaced every two years. Look at values from previous PMs to see if pressure transducers are swaying out of calibration. Are the high failure parts starting to fail? They should be stress tested to confirm they are not. Look for cracks in the bezel and case. A crack that is too big can create a nesting point for excess bacteria.
Serhan: During the pandemic, most hospitals purchased more IV pumps than they need. Better management of the IV pump fleet at the hospital can help reduce unnecessary costs and expenses. Purchasing pre-owned IV pumps can save the hospital over 50% than buying new ones. Make sure you seek reputable third-party companies with high-quality certifications and expertise on the pump model you’re interested in. In addition, having a trained HTM professional on site helps taking care of minor repairs and saving the hospital on repair costs.
Taltavull: Do your homework. There have not been many new products coming on the market over the past few years. So that means of the choices available, you should easily be able to consult your peers about their experiences with those products as well as the OEMs. Key questions need to be warranty, warranty exclusions, parts and service availability, and turn time on repairs. Last, but not least, remember you have service options.
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