Log in Article Discussion Edit History Go to the site toolbox

INF.D-01

From HTMcommunityDB.org

HTMC PM Procedure No. INF.D–01 rev 1 .……........…………….INFUSION PUMP

(This document was last revised on 4-5-16)

Scope:This procedure is to be used for .... Time required: 0.X man-hrs.

Test equipment and supplies required: IV pole; compatible unused IV set; IV container; collection vessel;hemostat; balance or scale; pressure gauge

Special precautions: If there is evidence of blood or body fluid contamination make sure the device is cleaned and decontaminated before attempting to work on it. ______________________________________________________________________________________________________
This is considered to be a relatively low PM-Priority device because it has no device restoration tasks that are critical (i.e. that would cause the device to fail while in use, with potentially disruptive consequences if they were not performed in a competent and timely manner), and also because the device has only a limited potential to develop a discoverable hidden performance or safety deficiency that could have a sufficiently serious consequence that the patient would be seriously injured.
________________________________________________________________________________________________________

[ ] R1. Verify that the device is functional. If it is not, check the box at the left and open a repair work order.__

Visual Inspection (VI) tasks) – predictive maintenance to detect any indications that components are beginning to fail.

[ ] VI1. With power off inspect the entire system for signs of damage, especially any moving parts, including any user-accessible areas that are under covers. Clean as needed. Adjust or replace any loose or damaged parts. Lubricate (if applicable) as required. Rate your finding for this task using the PHYSICAL CONDITION Finding scale described below and note your rating for this task (1, 5 or 9), here: __

[ ] VI2. Confirm that all markings and labeling are legible. Clean or replace, as required. __

[ ] VI3. Check that the physical condition of the power cord and cap, including the strain relief, is OK. Check the auxiliary receptacles (if applicable). Check the circuit breaker/ fuse. __

Device Restoration (DR) tasks – reconditioning or replacement of the device’s non-durable parts. (For specific "how to" instructions, refer to the manufacturer's PM procedure)

[ ] DR1. With power off inspect the entire system for signs of damage, especially any moving parts, including any user-accessible areas that are under covers. Clean as needed. Adjust or replace any loose or damaged parts. Lubricate, as required (if applicable). Rate your finding for this task using the PHYSICAL CONDITION Finding scale described below and note your rating for this task (1, 5 or 9), here: __

[ ] DR2. Confirm that all markings and labeling are legible. Clean or replace, as required. Note your rating for this task (1, 5 or 9), here: __

[ ] DR1. Check the battery, or replace it if so scheduled. Enter your rating for this task here: __ (If battery replaced per schedule, enter 1; if not scheduled and battery found to be OK enter 5; if not OK enter 9)

  • If battery replacement was not scheduled and it was no longer holding a charge [task rating = 9] this could have resulted in a delay in patient care until an alternate device is provided
Safety Verification (SV) tasks – to detect and correct any hidden performance/ safety degradations. (For specific "how to" instructions, refer to the manufacturer's PM procedure)

[ ] SV2. If there is exposed metal that could conceivably become energized, check the continuity to ground. (< 0.5 ohm). Note your finding from this task (A, B or F), here:__ (A finding rated at F could create the risk of a minor electric shock and possible patient injury - Level of Severity = LOS 2)

[ ] SV3. Verify that the battery charging system (if applicable) is operating within specifications. Note your finding from this task (A, B or F), here:__

[ ] SV4. Verify that the time/ date indication (if applicable) is correct. Note your finding from this task (A, B or F), here:__

[ ] SV5. Review the on-board error log/ event history for any unusual indications. Note your finding from this task (A, B or F), here:__

[ ] SV6. Verify the functional performance of all controls, switches, latches, clamps, soft touch keys, etc. including the keypad and the memory unit. Note your finding from this task (A, B or F), here:__ (A finding rated at F may cause over-infusion and a possible patient injury - Level of Severity = LOS 2)

[ ] SV7. Verify proper performance of all indicators and displays, in all modes. Note your finding from this task (A, B or F), here:__ (A finding rated at F may cause over-infusion and a possible patient injury - Level of Severity = LOS 2)

[ ] SV8. Verify that the flow rate or drip rate is within spec. Perform self-test if applicable. Note your finding from this task (A, B or F), here:__ (A finding rated at F may cause over-infusion and a possible patient injury - Level of Severity = LOS 2)

[ ] SV9. Verify that all alarms and any interlocks operate correctly, in all modes, including upstream and downstream occlusion sensors and the air-in-line detector. Note your finding from this task (A, B or F), here:__ (A finding rated at F may cause over-infusion and a possible patient injury - Level of Severity = LOS 2)

[ ] SV10. Check to ensure that free flow protection (if applicable) is active and operating properly. Note your finding from this task (A, B or F), here:__(A finding rated at F may cause over-infusion and a possible patient injury - Level of Severity = LOS 2)


FINDINGS-----------------------------------------------------------------------------------------------------------------------------------------------------

Rate the device's PHYSICAL CONDITION by giving the finding for each DR task a numerical code (1, 5 or 9), where 1 = Still good/ better than expected; 5 = About as expected; and 9 = Worn out/ serious physical deterioration.
Write in the numbers of any tasks marked critical (if applicable) where an out-of-spec (OOS) "9" condition was found: ____________ and provide details in the Note field below

Rate the PERFORMANCE/ SAFETY of the device by coding the finding for each SV task as an A, B or F . Where A = Passed; B= Minor OOS condition(s) found; F = Failed
Write in the numbers of any task marked critical (if applicable) where an out-of-spec (OOS) B or F condition was found:____________ and provide details in the Note field below.

Note . __________________________________________________________________________________________________

PM FINDINGS REPORT-------------------------------------------------------------------------------------------------------------------------------------------------

[ ] Device PASSED PM (all tasks marked critical are rated 1, 5, A or B)

When done, attach a new PM sticker indicating the next PM due date. PM interval: ___months.
Make sure all controls are set at normal positions and place a CAUTION tag in a prominent position asking the next user to verify the control settings and proper device set up before its next use.

[ ] Device FAILED PM (one or more tasks marked critical are rated 9 or F) --- LEVEL of critical PM task that was rated 9 or F; __1 (Life-threatening); __2 (Possible patient injury); __3 (Possible disruption of care)

If this is considered to be a PM Priority 1 device and if it DID NOT PASS it should be removed from service immediately.

[ ] Check here if all critical DR Tasks were coded 1 (This is an indicator that the PM interval may be TOO SHORT)
[ ] Check here if all critical DR Tasks were coded 9 (This is an indicator that the PM interval may be TOO LONG)
[ ] Check here if any critical SV Tasks were coded B (This is an indicator that these tasks should be considered for a future WATCH LIST)


HTMC PM Procedure No. INF.D–01 rev 1 ............................................... Date: _________ Initials: ________

_________________________________________________________________________________________________________
Disclaimer: This PM procedure may not reference all of the maintenance tasks specified by the manufacturer's technical or user manual. In many instances the manufacturer suggests a number of user-level tasks, such as cleaning or replacing consumables, which need to be completed. These are considered to be outside the scope of this technician-level procedure.


Site Toolbox:

Personal tools
This page was last modified 21:55, 17 July 2018. - This page has been accessed 9,984 times. - Disclaimers - About HTMcommunityDB.org