Equipment maintenance: Hospital Physicists' Association's views.
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This special report provides an overview of the ASHE Hospital Maintenance Staffing Study, which was conducted by the society in 1994-95 through the efforts of the ASHE Facilities Management Committee. The intent of the study was to develop a standard staffing equation to assist hospitals in determining appropriate maintenance staffing levels based on current practices of American Hospital Association member hospitals. Throughout the study, extensive survey data were collected and over 200 variables were considered. Statistical analyses were performed to determine which factors were most closely related to variations in staffing patterns, and whether staffing could be reliably predicted by a standard staffing equation. As with any benchmarking or other similar efforts, the results of this study should be approached with caution. There is variability in the data and the variability may change over time. However, the study has shown that high-quality predictability is possible Health care facilities will be able to use the resulting model to determine whether their staffing levels are significantly out of line and may help point to contributing factors.
Principal activities of maintenance carried out in hospital, staff required, various type of organization (inside team or global service), management aspects are described. Subjects responsible of maintenance are characterized and the relationships between Service of Maintenance and Service of Prevention and Protection in hospital are specified. Responsibility aspects concerning safety of maintenance workers and main risks which are exposed are defined. The importance of disponibility of a good maintenance handbook and of projects and programs of practice for new hospitals are emphasized.
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The Biomedical Instrumentation Department at Thomas Jefferson University Hospital maintains most of the clinical equipment owned by the hospital and provides support to six other hospitals, as well. In order to document these services, a computerized support system has been developed. This system maintains the inventory of equipment, documents the occurrence of repair and preventive maintenance procedures, generates lists of items due for maintenance and inspection, and prints reports and summaries of all activities performed by department staff. The system was designed for ease of use and requires a minimum of training for personnel who use it.
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Maintenance Department employees can be your friends and allies or the source of your biggest headaches. By working with maintenance personnel, the securing of maintenance areas can be made a lot easier.
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OBJECTIVE: To evaluate whether providing doulas during hospital-based labor affects mode of delivery, epidural use, breast-feeding, and postpartum perceptions of the birth, self-esteem, and depression. METHODS: This was a randomized study of nullipara enrollees in a group-model health maintenance organization who delivered in one of three health maintenance organization-managed hospitals; 149 had doulas, and 165 had usual care. Study data were obtained from the mothers' medical charts, study intake forms, and phone interviews conducted 4-6 weeks postpartum. RESULTS: Women who had doulas had significantly less epidural use (54.4% versus 66.1%, P < .05) than women in the usual-care group. They also were significantly (P < .05) more likely to rate the birth experience as good (82.5% versus 67.4%), to feel they coped very well with labor (46.8% versus 28.3%), and to feel labor had a very positive effect on their feelings as women (58.0% versus 43.7%) and perception of their bodies' strength and performance (58.0% versus 41.0%). The two groups did not differ significantly in rates of cesarean, vaginal, forceps, or vacuum delivery, oxytocin administration; or breast-feeding, nor did they differ on the postpartum depression or self-esteem measures. CONCLUSION: For this population and setting, labor support from doulas had a desirable effect on epidural use and women's perceptions of birth, but did not alter need for operative deliveries.