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Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings.

Publication ,  Journal Article
Malkin, R; Keane, A
Published in: Medical & biological engineering & computing
July 2010

Much of the laboratory and medical equipment in resource-poor settings is out-of-service. The most commonly cited reasons are (1) a lack of spare parts and (2) a lack of highly trained technicians. However, there is little data to support these hypotheses, or to generate evidence-based solutions to the problem. We studied 2,849 equipment-repair requests (of which 2,529 were out-of-service medical equipment) from 60 resource-poor hospitals located in 11 nations in Africa, Europe, Asia, and Central America. Each piece of equipment was analyzed by an engineer or an engineering student and a repair was attempted using only locally available materials. If the piece was placed back into service, we assumed that the engineer's problem analysis was correct. A total of 1,821 pieces of medical equipment were placed back into service, or 72%, without requiring the use of imported spare parts. Of those pieces repaired, 1,704 were sufficiently documented to determine what knowledge was required to place the equipment back into service. We found that six domains of knowledge were required to accomplish 99% of the repairs: electrical (18%), mechanical (18%), power supply (14%), plumbing (19%), motors (5%), and installation or user training (25%). A further analysis of the domains shows that 66% of the out-of-service equipment was placed back into service using only 107 skills covering basic knowledge in each domain; far less knowledge than that required of a biomedical engineer or biomedical engineering technician. We conclude that a great majority of laboratory and medical equipment can be put back into service without importing spare parts and using only basic knowledge. Capacity building in resource-poor settings should first focus on a limited set of knowledge; a body of knowledge that we call the biomedical technician's assistant (BTA). This data set suggests that a supported BTA could place 66% of the out-of-service laboratory and medical equipment in their hospital back into service.

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Published In

Medical & biological engineering & computing

DOI

EISSN

1741-0444

ISSN

0140-0118

Publication Date

July 2010

Volume

48

Issue

7

Start / End Page

721 / 726

Related Subject Headings

  • Medically Underserved Area
  • Maintenance and Engineering, Hospital
  • Humans
  • Evidence-Based Medicine
  • Equipment and Supplies, Hospital
  • Equipment Reuse
  • Equipment Failure
  • Developing Countries
  • Clinical Laboratory Techniques
  • Capacity Building
 

Citation

APA
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ICMJE
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Malkin, R., & Keane, A. (2010). Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings. Medical & Biological Engineering & Computing, 48(7), 721–726. https://doi.org/10.1007/s11517-010-0630-1
Malkin, Robert, and Allison Keane. “Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings.Medical & Biological Engineering & Computing 48, no. 7 (July 2010): 721–26. https://doi.org/10.1007/s11517-010-0630-1.
Malkin R, Keane A. Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings. Medical & biological engineering & computing. 2010 Jul;48(7):721–6.
Malkin, Robert, and Allison Keane. “Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings.Medical & Biological Engineering & Computing, vol. 48, no. 7, July 2010, pp. 721–26. Epmc, doi:10.1007/s11517-010-0630-1.
Malkin R, Keane A. Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings. Medical & biological engineering & computing. 2010 Jul;48(7):721–726.
Journal cover image

Published In

Medical & biological engineering & computing

DOI

EISSN

1741-0444

ISSN

0140-0118

Publication Date

July 2010

Volume

48

Issue

7

Start / End Page

721 / 726

Related Subject Headings

  • Medically Underserved Area
  • Maintenance and Engineering, Hospital
  • Humans
  • Evidence-Based Medicine
  • Equipment and Supplies, Hospital
  • Equipment Reuse
  • Equipment Failure
  • Developing Countries
  • Clinical Laboratory Techniques
  • Capacity Building