TRIAL OF A MULTI-COMPONENT PROGRAM TO IMPROVE THE EFFECTIVE USE AND
MAINTENANCE OF SELECTED MEDICAL EQUIPMENT IN A LOW-RESOURCE SETTING
Abstract
Background: Medical equipment (ME) maintenance retains an
asset’s original anticipated useful life and preserves its reliability
and cost-effectiveness. This study developed and trialled a
multi-component program to improve ME maintenance in nine Sri Lankan
hospitals. Methods: This pre-post study involved an initial
baseline assessment of existing ME maintenance systems in nine
hospitals, the development and implementation of a multi-component
improvement program, and a three-month post-evaluation. Five target ME
were selected for the study: oxygen regulators, electrocardiogram (ECG)
machines, suction apparatus, blood pressure (BP) apparatus and mini
autoclaves. A validated questionnaire of randomly selected nursing
officers (n=101) and healthcare assistants (n=120) was used to obtain
baseline ME maintenance data. Six focus groups and 24 interviews were
conducted with key stakeholders to co-design the multi-component
interventions, which included: developing a standard operating procedure
(SOP) targeting preventive maintenance activities; establishing focal
points to provide technical and logistic support; staff training; and
the introduction of institutional ME maintenance documents. Program
effectiveness was assessed at three months post-implementation.
Results: Baseline assessment identified no ME maintenance
programs implemented in any of the hospitals. Following program
implementation, improvements were noted in: the availability
(p<0.05) and functional level (p<0.05) of all
selected ME; equipment maintenance processes (p=0.000); as well as staff
knowledge, skills, perceptions and satisfaction. Conclusions:
The program improved the use and maintenance of ME and was widely
supported by key stakeholders. The approach is likely relevant to other
resource-poor hospital settings where inadequate ME maintenance causes
health system inefficiencies.