Today, I write from the perspective of the other side of equipment. I, unfortunately, needed to spend some time in my hospital as a patient. These situations are always stressful and frightening. I used the experience to assess how our medical equipment management plan works and if the message gets to the nursing team.
I was admitted in the off shift for catheterization, I had been experiencing chest pains on and off for a week, but did not have any other symptoms. To make a long story short, one our most gifted cardiologist saw something on my EKG that no one else detected and decided we were going to the cath lab. This situation exposed me to our emergency department, our cath lab, our ICU and our step down unit. I can’t imagine a better sampling of departments to evaluate our plan. For my problem, they used X-ray, ultrasound, EKG machine, patient monitors, IV pumps and scales. I know this sounds odd; I should have been focusing on taking care of myself first. However, I had a lot of down time to think. I am not very good at turning off work. So, I used this situation to my advantage and to get a perspective that I had never considered in all my years here.
Although this situation was frightening I was able to observe staff actually utilizing the equipment. I was able to see firsthand if staff really knew what was going on with their equipment and if they knew how to use it correctly. What also made the evaluation more impactful is that I was admitted during the second shift, which means we had a lot of newer nurses on and even some agency nurses. Luckily for me the catheterization procedure went very well, all the equipment worked as expected, no delays or complications. They did what they needed to do and had me in the ICU in about an hour. However in the ICU they had me connected to an IV pump that started beeping “low battery.” I summoned the nurse who checked the pump and stated it wasn’t charging. I resisted telling him why (they had the cord wrapped tightly on the mount and damaged the strain relief). He checked the plug and the cord and decided to change the pump out. I watched with pride as he put the red defective label on the pump and sent it to be cleaned. One test passed! The next issue I had was a telemetry transmitter, I noticed it lit up in my pocket and beeped with a message to “discharge patient.” I paged the nurse, she reset the box and went on her way. The unit worked for about 10 more minutes and then did the same thing again. This time I waited a little before calling the nurse, I wanted to see if the telemetry tech would notice the problem. Within a few short minutes the nurse came back in with a new telemetry transmitter to replace the malfunctioning one. I felt great that they solved the problem perfectly.
As I was going through this situation with my health and worrying about what was happening to me, I felt good about the equipment they were using to diagnose me. I am a strong proponent of evidence-based maintenance and AEM principles. I feel patient safety is not impacted by the decisions to implement these strategies. However, the decision becomes very real when they are hooking up that monitor to you or diagnosing you with an ultrasound because they can’t figure out what is going on. I was not worried at all about the information the clinicians were getting from the equipment. Frankly, when they did get a reading that did not make sense they just redid it to make sure the reading was true.
I know that sometimes I feel like the people using and breaking the equipment are careless and clueless, but I found out that the majority of our clinicians are really smart people. They know how to use the equipment, they know how to follow policies and they know how to take care of people. I feel good that our equipment management plan is followed and mostly understood, even if they don’t know they are following a plan.
For me, my situation is only going to get better, they found a blockage, fixed me up and I feel better than ever. I can’t wait to get back outside to enjoy the outdoors.
Jim Fedele, CBET, is the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/or comments via email at firstname.lastname@example.org.
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