What Evidence If Any Did You See Of Light Repair

• Journal List
• Community Heart Health
• 5.23(73); 2022 Sep
• PMC2975114

Community Heart Wellness. 2022 Sep; 23(73): 26–29.

Equipment maintenance and repair

Jane Huria

Instrument Repair Technician, Center Unit, PCEA Kikuyu Infirmary.

Ismael Cordero

Senior Clinical Engineer, ORBIS International, 520 eighth Ave, llth Floor, New York, NY 10018, U.s..

The repair and maintenance of ophthalmic equipment, including surgical instruments and diagnostic devices, can be compared to the maintenance of a motor vehicle, something many of united states of america understand well.

If you had a car, would you drive it until the fuel runs out or until a tyre punctures, and so carelessness it to buy a new motorcar? Of course not. Withal, many eye intendance units purchase (or receive as a donation) expensive and delicate equipment which, because of poor maintenance, ends up breaking downward. If there is non a arrangement in identify to report breakdowns and to plan or carry out repairs, equipment can remain unusable for long periods of time. Sometimes, this equipment ends up existence dumped. (Figure ​ 1).

An operating tabular array lies abased outside a hospital in a low-income country.

Ismael Cordero/ORBIS

Good maintenance habits and an constructive repair organisation volition minimise the amount of fourth dimension equipment is unusable.

Who does what?

In our feel, approximately one-third of bug reported with ophthalmic equipment arise from bug caused by the user, one-third from easy-to-solve technical issues (such as a diddled bulb or fuse, or a loose power string), and only one-third crave more serious error-finding procedures and special knowledge of the equipment. Equipment users therefore accept a significant role to play in the everyday care and maintenance of equipment.

Unremarkably, a well-balanced mix of user, in-house, and outsourced maintenance and repair leads to the all-time results - both technical and financial - in settings with express resources. If information technology is not feasible for an center care unit of measurement to have an in-house equipment maintenance and repair team, you may consider sharing such a service among several units. Depending on the equipment, you may take a service contract with the vendor or manufacturer, who volition exist responsible for more circuitous maintenance and repairs. These will exist carried out past specialised maintenance and repair personnel, either employed by the vendor or manufacturer, or working every bit independent maintenance contractors. Whatever system your eye unit has in identify, the maintenance and repair of equipment should be centrally managed. The person responsible (the 'equipment person') volition assign tasks, proceed maintenance and repair records, design maintenance schedules, and adjust the necessary training of staff.

Sometimes, maintenance or repair support may be required from vendors and other external maintenance contractors. In all of these instances, it is important that a designated person at the eye care unit of measurement is monitoring the responsiveness, quality, and cost of the service provided.

'The maintenance and repair of equipment should be centrally managed'

Preventative maintenance

Preventative maintenance prevents breakdowns and ensures that equipment is operational and safe to use. It likewise guarantees the accuracy and reliability of equipment (that the autoclave sterilises properly and the keratometer readings are correct, for instance) and saves money: it can reduce the running costs of equipment and is cheaper than repairs following a breakdown.

Preventative maintenance consists of a number of tasks of varying technical complication, carried out by different groups of people.

• Equipment users, including clinic and operating theatre staff, can be trained to perform many of the uncomplicated care and maintenance duties that need to be done on a regular basis, such equally dusting, cleaning, lubricating, protecting, and checking equipment, including safety checks.

• Other maintenance tasks can exist performed by an in-firm or shared maintenance and repair squad that has been given additional training. These include tasks such as cleaning a microscope lens, replacing an electronic component, performing a mechanical aligning, or any other activeness that requires mechanical skills and/or a knowledge of electronics.

• More complex work has to be done by specialised maintenance and repair personnel contracted or employed by the vendor or manufacturer.

Preventative maintenance schedules

It is important to accept a schedule for preventative maintenance of each item of equipment. This consists of a timetable stating when (and how frequently) maintenance should be done, and a listing of maintenance activities for each item. These schedules should provide simple guidelines for all types of equipment, covering the tasks to be undertaken in the following areas:

• Care and cleaning

• Prophylactic checks

• Functional and operation checks

• Maintenance tasks (changing bulbs, lubricating moving parts, etc.)

The all-time source of this information is ordinarily the manufacturer's user and/or service manual.

Schedules demand to be developed separately for both users and maintainers. For example, users can perform checks and basic maintenance tasks on a daily basis, whereas the maintenance team tin can set aside a specific twenty-four hour period of the week or month to bear out regular maintenance tasks. More sophisticated maintenance tasks, such as those which need to be carried out past service agents, should exist scheduled for a specific day or week in the year.

It is helpful to display maintenance schedules for users on or virtually the equipment they refer to; this can serve as a useful daily reminder of the tasks that should exist performed.

Repair

Repair means responding to the breakup of equipment and undertaking work to correct the trouble in order to return the equipment to a working condition.

Before equipment can exist repaired, you need to be aware that there is a trouble! Therefore, in that location should be a conspicuously understood system for reporting faults and breakdowns and equipment users should be encouraged to report faults and breakdowns equally soon every bit possible. If at that place is no redundancy equipment, a breakup will mean that the service the equipment was providing volition come to a halt.

Simple repairs can exist done by the in-business firm or external maintenance and repair team. If the equipment is repaired where it is used, information technology is of import that the team is trained to work safely and that they don't create hazards for patients or staff.

More complex repairs will exist carried out by specialised maintenance personnel; they might come to the eye care unit or you may accept to send the equipment to them for repairs.

In all these situations, information technology is important to keep equipment users informed of how long their equipment volition be unavailable.

Some items of equipment will exist constitute to exist damaged beyond repair. For others, spare parts may no longer be available as the equipment has become outdated. These will have reached the end of their lives and must be taken out of service (decommissioned or retired) and be replaced if the service they provide is to continue. Equipment that is being decommissioned should be disposed of safely and co-ordinate to proper disposal procedures. Remember to update your records accordingly.

'Plan for maintenance when you buy the equipment'

Record-keeping

In order for an eye care unit to manage its equipment finer, information technology needs good maintenance and repair records. It is very difficult to manage the unknown!

A fundamental maintenance and repair record volition assist yous to keep rail of the maintenance and repair piece of work done. Ideally, this arrangement should represent to the center unit's equipment inventory (mentioned on folio 34); this means that y'all volition have maintenance and repair records for each of the items listed in the inventory.

Record-keeping for maintenance

The preventative maintenance schedule for users tin can be accompanied past a weekly or monthly 'tick sheet' about the item of equipment, with a infinite for each day so that users can engagement and sign information technology, thereby showing that they have carried out the required tasks. This may include a space for users to indicate what spare parts, such as bulbs, were used. On a regular basis, the list of spare parts used should be noted in the central maintenance and repair record so that more than spare parts can be ordered.

The central maintenance and repair record can be used to go on runway of all other maintenance, including maintenance washed by the in-house team, past vendors, or by service agents. The information captured should include the engagement, the equipment reference number, what was done, who did the piece of work, and when next maintenance is due.

One way of keeping track of regular maintenance tasks is to affix a tag to serviced or maintained equipment. This information should be reflected in the central maintenance record.

Ismael Cordero/ORBIS

Record-keeping for repair

Table ​ ane shows what data about repairs should be recorded in the central maintenance and repair record, and what useful information this tin provide.

Tabular array one

Record-keeping for repair

What should be recorded	This provides data about…
The details of repair work done on each machine (including cause/suspected crusade, and who carried out the repair)	The history of each machine Common issues
The spare parts and materials used	The parts most oft used What needs to be re-ordered
The date equipment has broken downward, and the date it is repaired.	What still needs to be repaired (which allows yous to prioritise the next week's tasks) The elapsing equipment is non in use (down-time)
The causes of whatsoever delays	What the virtually common causes of delays are (skill, labour, spare parts, ship, bureaucratic delays, coin) and what additional resources may be needed to consummate work on time

In addition to the practical benefits of a cardinal maintenance and repair system, it also provides eye intendance unit administrators and the equipment maintenance squad with valuable information and proof that they tin can employ to enquire for more resources.

Budgeting for maintenance and repair

When we buy a motor vehicle, nosotros understand that we will have recurring costs for maintenance, theft and accident insurance, cleaning, parking, etc. The same is true for ophthalmic equipment since it costs money to operate and to maintain during its life cycle.

On boilerplate, the original buy cost simply makes up nigh twenty per cent of the entire life cycle cost of the equipment. As a general dominion, y'all should budget anywhere from 3% to 6% of the equipment purchase cost per yr for each device to cover consumables, parts, maintenance, and user grooming.

Plan for maintenance when yous purchase the equipment and ensure that you buy the necessary accessories (including voltage stabilisers/surge protectors and uninterrupted ability supply units) as well as plenty spare parts (bulbs, fuses, and so on) to last for at least a year.

In decision, adopting practical and workable systems to manage centre care equipment, as suggested in this article, volition aid y'all to become the nearly use out of the equipment you have. With equipment, prevention is commonly meliorate than cure! It is also skilful exercise to proceed learning and to stay open up to new ideas. Communicate with colleagues in other eye units, whether locally or through the internet, about the challenges you face and share with them the solutions you lot take found.

Acme TIPS Equipment care

Tools

Where possible, avoid using hammers, pliers, and files: these usually cause irreparable damage. Utilise the right tool to tighten screws and other parts.

Lubrication

• Petroleum jelly (Vaseline) or white grease is good for lubricating parts that have gears or sliding surfaces. It is clear and less likely than regular grease to exit stains on hands and clothing.

• Silicone spray is useful for sliding plastic or nylon parts. Have intendance not to spill whatsoever on the flooring as it is very slippery and hard to remove.

• Graphite can be used as a dry lubricant (or as a paste) for moving or sliding parts.

• Avoid excessive apply of oil as it is messy and collects dust.

Foot pedals

These oftentimes become wet when floors are beingness cleaned, especially in the operating theatre. Moisture seeps into the electrical components of the foot pedal which with time volition stop working. Always place any foot pedal off the floor when mopping.

Wires and optical fibres

Wires and optical fibres from equipment such as light amplification by stimulated emission of radiation machines, vitrectors, indirect ophthalmoscopes, etc. have very delicate interiors and/or optical components within them, and some of them may carry ability or electricity and rut up with use. Staff should know how to handle and fold them properly in gild to prevent impairment. In situations where wires and fibres have to lie on the floor, they should not be walked on or run over with heavy items such every bit trolleys or other wheeled furniture and equipment.

Lenses

Protect lenses from dust by always covering optical equipment when non in use.

Humidity, or liquid spilled on instruments, can cause fungal growth (mould) on lenses. Many producers of optical equipment supply sachets of silica gel drying agents or fungicidal (anti-mould) pellets that you can place inside the dust cover. You tin also use a dehumidifier to continue the air in the room dry.

Electrical connections

Pulling on the cord instead of on the plug can impairment the wires.

Matt Baretich

Check that equipment is plugged in properly and that the cord is not in danger of shorting (for example, if information technology is exposed to water or steam) or in danger of existence cut.

Handle plugs (or connectors) with intendance. A break in a wire inside the plug casing is hard to find and causes equipment to work intermittently. This can result from bending the wire at the same place or unplugging from the socket by pulling on the cord.

Power sources

Expensive and delicate equipment such as bench-top autoclaves, lasers, microscopes, slit lamps, and vitrectors can be severely damaged past sudden surges in electricity. Using a voltage stabiliser or regulator volition protect equipment against damage and will generally besides prolong the life of equipment. We recommend good quality units which monitor the mains voltage continuously. Await for units which volition stabilise the output to ensure the voltage reaching your equipment remains constant at 230V (±6%). If the input voltage falls below 142V or rises above 295V, the stabiliser volition automatically disconnect the output. Stabilisers of poorer quality may exist overwhelmed by big fluctuations, which will then damage whatsoever connected equipment.

The use of an uninterrupted power supply (UPS) unit is strongly recommended for equipment such A-scans, visual field analysers, fundus cameras, lasers, and operating microscopes. This ensures continuous operation of the equipment and less inconvenience for both surgeons and patients when there are power failures. Nosotros recommend using a UPS that is likewise able to act as a voltage stabiliser and protect the equipment against power surges. The blazon of UPS and its power output requirements can hands be adamant by a qualified electrician. Equipment suppliers may as well be able to requite these details.

Using equipment for outreach

Equipment and instruments that are transported for outreach work need to be packed and carried with special precautions so they are not damaged in transit.

Heavier equipment such as operating microscopes should exist carefully dismantled and packed in harm-proof containers. Specially designed microscopes for mobile use are available with proper packing containers for safe send.

Sufficient stock of low-cal bulbs and fuses should be carried together with a set of spiral drivers and other basic tools. Staff travelling with outreach programmes should know how to pack, fix, and dismantle the equipment.

With thank you to Ingrid Mason, Neil Murray, Kola Ogundimu, Sam Powdrill, Tony Walia, and Ismael Cordero.

What YOU tin can do to look after your equipment

Care and maintenance of equipment is anybody'south responsibility; unusable equipment affects the quality of care we tin offer our patients and makes our work more than stressful.

Whatever your role in the eye care team, there is a lot you can do to look after and prolong the life of the equipment you use.

1. Learn as much every bit you can about the equipment you use

   • Find out where the manual is kept-and make time to read it. If possible, go on the manuals close to the equipment.

   • Brand certain you get every issue of the Community Eye Health Journal over the side by side three to 4 years - nosotros are publishing a new series on equipment care, maintenance, and repair which will have practical tips and guidance on the most used items (see the beginning instalment on folio 37).

   • Look at 'Useful resources' (page 36) for additional sources of information.

2. Cheque equipment earlier use (or at to the lowest degree once a calendar week)

   • Inspect equipment for any sign of harm or parts that may need repair or replacement, and lubricate as necessary (according to instructions).

   • Bank check that equipment is plugged into the voltage stabiliser or uninterrupted power supply, where these are required.

3. Tell someone if there is a trouble

   • Equally a user, it is your responsibleness to report any problems. You will most likely be the first person to know that something is non working as it should.

   • Don't assume that someone else will report a mistake-what if everyone thinks that someone else will written report it?

   • It may sound obvious, but a repair can't be attended to if nobody knows in that location is a problem. The longer you take to report it, the longer before the repair will accept place.

   • Don't wait for equipment to break down before reporting a fault. Fifty-fifty a small change in how the equipment moves or how it responds could signal that something has gone wrong or that a part needs to be replaced before long. If left unchecked, a more serious error may occur, which will be more expensive and time-consuming to repair.

4. Make clean equipment after apply (or at least in one case a twenty-four hour period) and lubricate when necessary

   • Grit and so make clean equipment, including optical components, with the appropriate cleaning agents and solutions. Lubricate moving equipment as oftentimes as indicated. E'er follow the instructions.

5. Protect equipment when non in utilise

   • Shop equipment in a dry, clean environment where it is not in danger of falling and breaking.

   • Identify plastic dust covers on larger equipment like slit lamps in order to prevent impairment to the optics and other delicate components. If fabric is used, ensure it is heavy and non-porous, or else grit volition get through.

   • When transporting equipment, pack items deeply and handle with intendance.

Contributor Information

DS Walia, Director of Clinical Services: Eye Unit of measurement, PCEA Kikuyu Hospital, PO Box 45-00902, Kikuyu, Kenya. Email: gro.latipsohuyukikaecp@eyescd.

Jane Huria, Instrument Repair Technician, Center Unit, PCEA Kikuyu Infirmary.

Ismael Cordero, Senior Clinical Engineer, ORBIS International, 520 8th Ave, llth Floor, New York, NY 10018, Usa.

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Manufactures from Community Eye Health are provided hither courtesy of International Centre for Eye Health

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975114/

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