2014年7月29日 星期二

如何讓醫院評鑑之醫工角色受到重視


(http://bme.freebbs.tw 醫學工程論壇同步發表)


最近在醫院工作的夥伴應該都有收到

醫策會又在廣徵意見要大修104年的評鑑條文了

有關醫工的主要條文1.6.9中...還是一樣的老問題,要評醫工又不敢提醫工,真的會讓人吁嘆...

希望各位在醫院的醫工夥伴,主動跟貴院管理部門連絡,跟他們反映,

1.6.9 A.2 專責人員或部門具有相關工務專業或證照。
------>工務要改成醫工
就算只把"工務"拿掉,也不夠突顯醫工的角色,所以一定要加"醫工"二個字

大家一起來反應,讓醫工的角色在醫院中可以更明確,更受肯定。

2014年7月28日 星期一

一級召修 GE Healthcare, LLC, Single-Width Airway Modules (E-MiniC) and Accessories and Extension Modules (N-FC, N-FCREC: Class I Recall - CO2 Detector May Fail Leading to Injury


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GE Healthcare, LLC, Single-Width Airway Modules (E-MiniC) and Accessories and Extension Modules (N-FC, N-FCREC) - CO2 Detector May Fail Leading to Injury

 E-MiniCN-FC, N-FCREC
Recall Class: Class I
Date Recall Initiated: June 11, 2014
Products: Single-Width Airway Modules (E-MiniC) and Accessories and Extension Modules (N-FC, N-FCREC)
這是搭配呼吸器或生理監視器模組,QSD無法查到獨立申請
字號,請有使用GE類似產品的人,若有使用用到該模組,
注意一下是否有影響的序號產品。
Manufacturing Dates: February 10, 2012 through October 2, 2012Distribution Dates: February 2012 to April 2014
Affected Product Details:
  • Single-Width Airway Modules (E-miniC) -Serial Numbers 6818561 through 6898777.
  • The Extension Modules N-FC and N-FCREC - Serial Numbers 6799191 through 6905206.
  • The serial number can be found on the device plate attached to the module.
Modules serviced with FRU (Field Replaceable Unit) catalog number M1013204 (miniC Unit, N-FCREC) between February 2012 and May 2014 may also be affected by this recall.
Use: These devices are used in hospitals and other health care facilities for monitoring CO2 and respiration rates in patients weighing over 11 pounds (5 kg).
Recalling Firm:GE Healthcare, LLC
3000 North Grandview Boulevard
Waukesha, Wisconsin 53188-1615
Manufacturer:GE Healthcare Finland Oy
Kuortaneenkatu 2
Helsinki, Finland 00510
Reason for Recall: The affected CO2 detectors may fail or provide incorrect CO2 values for mechanically and spontaneous ventilated patients. Physicians may make decisions based on incorrect values which could lead to permanent, irreversible impairment or life-threatening changes in patients.
Patients may experience an inadequate exchange of gases (hypoventilation), causing an increased concentration of CO2 (hypercapnia). Death may also occur as a result of low CO2 values.
There are no reports of injuries or deaths associated with the malfunctioned devices.
Public Contact: For questions about this recall, customers may contact GE Healthcare Technical Support at 1-800-558-7044, Monday - Friday, 8:00 a.m. - 5:00 p.m., Central Time or the local service representative.
FDA District: Minneapolis District Office
More Information about this Recall:On June 11, 2014, the firm sent an Urgent Medical Device Correction letterdisclaimer icon to their customers. The letter identified the affected products and problem and provided safety instructions. Customers should read the letter and follow the instructions provided.
About Class I Recalls:Class I recalls are the most serious type of recall and involve situations in which there is a reasonable probability that use of these products will cause serious adverse health consequences or death.
Health care professionals and consumers may report adverse reactions or quality problems they experienced using these products to MedWatch: The FDA Safety Information and Adverse Event Reporting Program either online, by regular mail or by FAX.

2014年7月17日 星期四

熱毯灼傷女嬰 業者:嬰兒禁用

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熱毯灼傷女嬰 業者:嬰兒禁用 (原出處)

節錄..
婦產科主治醫師黃XX(07.15):「可能就是電毯它的溫度失控,可能比預期的高,所以(女嬰)才會有水泡,這個不是我們可以預期的,因為我們使用這個,也是個醫療器材,它「開」了之後,它就是(運作)15分鐘45度C,所以醫護人員,並沒有必要再去做改變。」
熱敷毯業者譚XX:「他第一個使用方法就錯誤了,所以他並不是OK的,它就是不能使用在嬰兒身上,第一個方式就是不OK了。」.........

-------------------------

這款是SUMO舒摩熱敷墊 衛署醫器製壹字第001391號  ----物理醫學科用裝置

公告動力式熱敷墊(Powered heating pad)應加註警語相關事宜【發布日期:2012-11-29】

出問題了,就是先推給設備,還好這東西在使用方法上有註明禁用於嬰兒...

問題又來了...

當初誰買的? (採購?)  

誰說可以用在嬰兒上的(業務?還是自己覺得可用?)

因為這是診所,一定不會有醫工,但如果在醫院裡,如果醫工有辦理驗收,要記得這是不能用於嬰兒的,說明書上第一條有註明哦。

但在醫院裡,我們還是要清查一下,是不是真有人把他拿去用在嬰兒身上?

除此之外,可能所有相關的設備,如保溫燈,加嬰兒保箱、加溫處理台....及保養檢測記錄,要注意。

今年的各地衛生局查核這項會列入查核重點。

2014年6月20日 星期五

2014評鑑感言...6/18~20-->今天剛結束

1.6.9著重在保養排程的橫向通知 (其實1.6.10及1.6.11也都類似)

以前提專業分工,所以保養由專業單位執行,使用單位對設備的保養可能不會很關心甚至於不聞不問,反正只要有人做就好了,所以上次99年評鑑時都著重在專業單位的檢查。

這次的評鑑的重點,不只管理組,連醫護組都會交叉詢問基層人員對於設備保養的認知;除了確認醫工或專業單位人員,是否有落實保養之外,也開始要求基層人員對自己使用的設備相關的保養及安全認知,不希望使用單位人員傻傻的用,這是不錯的方向。

如,胃鏡室的清洗機,是否有定期更換及巡檢,除了機器的功能正常外,對於消毒液的揮發是否有認知會危害健康,所以不只專業單位會定期檢查,使用單位的人也要知道有沒有人己經來維修保養過了。

又如,到開刀房、復健科...問到基層人員,設備保養排程在哪可以看到,設備送修如何確認己在處理及追?

在這個論點下,使用單位的人員就必需知道                        
  使用單位需知道事項
  
  醫工或專業單位的措施
  
  你用的設備,保養排程在哪可以看到
  
  如何公告週知:網頁或維修系統公告
  如何宣導各單位人員知道何處隨時可查到保養排程及進度:辦院內說明會,網頁上公佈流程
  
  什麼時候會來保養
  
  保養排程:註明月或季的順序,方便查詢
  保養標籤要有本次,下次保養日期及人員簽章
  
  多久保養一次
  
  在公告上註明保養週期或是財產或保養標籤上註明
  
  有沒有來保養,你怎知道  保養通知:電話、Email
  
  保養內容是否可以確實保障使用者及病人的安全
  
  保養基準:要有保養到重點
  保養記錄:要有使用單位簽名
  保養進度追及檢討改善過程的記錄:PDCA
  
維修單的開立--->電腦或紙本,都OK留有記錄可查
維修進度的告知--->零件申請,
維修結果--->通知使用單位領回及驗收簽認,維修統計及檢討記錄,


要達到這些,不是作資料就可以應付的,現在各家醫院的維修保養系統都應該建立了,重點是有沒有讓使用單位的人員知道如何使用,而不是專業單位在自爽而已。
配合建立這些系統,當然院內的相關辦法、作業流程、個人辦事細則、保養基準…也都要事先建立符合實況。

2014年5月25日 星期日

學用落差

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「學用落差因應策略論壇」---

面試亂穿、遲到也不講--->
這可能不是在大學就養成的,是生活及社會教育的氛圍所造成的,強調一如創意工作強調自由性及自主性,結果一堆人只看到舒適面,拿來一體適用,結果呢,就造成這種結果。

大學文憑沒有鑑別度--->
大學真的太多了,碩、博士也是快到這下場了。

機械系竟沒摸過馬達--->
產、官、學界的落差真的是有了,學校老師有時太偏研究,跟實務面脫節很多;所以機械系學生沒摸過馬達,我們醫工科系中電子相關學程的學生沒拿過或不會用烙鐵的,電子零件符號看不懂、不會分辨色碼阻值的有嗎,應該也是有的.......

我個人覺得,以醫工來說,可能有的老師可能太偏研究面,研發、了解產品。但醫工產業還有醫院這一環,醫院裡的醫工及各項制度,真的有多少老師在這方面了解,可以教給學生?
有專業證照加薪一萬---->
科大專注證照沒話說,大學除了研究也是要了解到現實面,但我們的證照呢..


2014年5月10日 星期六

一級召修Hospira Inc., GemStar Docking Station

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Hospira Inc., GemStar Docking Station (List Number 13075) – Potential for Error or Failure to Power Up (原出處)



搭配使用GemStart使用的Pump座 ,國內沒特別註記有這款QSD申請,但個人認為有時會被認為是配件沒特別申請,直接建議使用,如果各位醫院裡有類似的裝置,建議還是問一下原廠,RECALL的處理狀況。

特別是如果沒QSD的話,要記得撤下勿使用。因為藥事法己修訂,零件、配件、軟體都歸屬QSD管制範圍。


((國內引進的型號13000,13150。13086, 13087, 13088))


Recall Class: Class I
Date Recall Initiated: February 18, 2014
Product: GemStar Docking Station (List Number 13075), used in conjunction with GemStar Infusion Pump
The GemStar Docking Station is a separately sold accessory to the GemStar infusion pump and provides an alternate power source to the GemStar pump
The affected GemStar Docking Station was manufactured from July 2002 through March 2013 and distributed from July 2002 through December 2013.
搭配使用GemStart使用的Pump座 ,會影響所使用的PUMP型號如下表
The products affected by this recall are identified below:
Affected Docking Station ProductCodeWhen Used with These Models of Infusion PumpsWith the Affected List NumbersMay Result in the Following Malfunction
  13075GemStar Phase 3 Pumps13000, 13100, 13150Fail to Power Up
GemStar Phase 3 Pumps or
GemStar Phase 4 Pumps         
13000, 13100, 13150
13086, 13087, 130088
Error Code 11/003
Use: The GemStar Docking Station is used in the post-operative hospital setting where the GemStar pump provides pain/patient control anesthesia (PCA) infusion in combination with other GemStar Accessories. The GemStar pump is often used to inject anesthesia into the spine prior to giving birth. The GemStar pump can also be used for other general infusions such as IV medicines and feeding solutions, antibiotics and cardiovascular solutions.
Recalling Firm:
Hospira Inc.
275 N Field Dr
Lake Forest, Illinois 60045-2579
Reason for Recall:
The firm received customer reports of two potential malfunctions that may occur with the GemStar Docking Station. To date, there have been no reports of death or serious injury associated with these malfunctions.
When the docking station is used with a GemStar Phase 3 pump (List 13000, 13100 or 13150), the GemStar pump may fail to power up while connected to the docking station which may cause a delay of therapy.
When a GemStar Phase 3 pump (List 13000, 13100 or 13150) or GemStar Phase 4 pump (List 13086, 13087 or 13088) is used with both a docking station and an external battery pack accessory (List 13073), there is a possibility that the GemStar pump will display error code 11/003 which will trigger an audible alarm, indicating excessive input voltage (more than 3.6 Volts). The pump will then stop the infusion which may cause a delay of therapy.
The use of this affected product may cause serious adverse health consequences, including death.
Public Contact: For further inquiries, please contact Hospira using the information provided below:
Hospira ContactContact InformationAreas of Support
Hospira Global Complaint
Management
1-800-441-4100 (M-F, 8 am-5pm, CT)
ProductComplaintsPP@hospira.com
To report adverse events
or product complaints
Hospira Advanced
Knowledge Center
1-800-241-4002, option 4
(Available 24 hours a day/7 days a week)
Additional information or
technical assistance
FDA District: Chicago District Office
More Information about this Recall: On February 18, 2014, Hospira sent an Urgent Medical Device Correction letter to all its direct customers. Customers are requested to complete and sign the reply form and return it to the fax number or email address on the form.
Hospira recommends the following:
There is no need to return the GemStar Docking Station at this time.
Healthcare professionals should weigh the risk/benefit to patients associated with the use of the device when administering critical therapies. Customers should consider the use of an alternative pump, particularly in patients in which a delay/interruption in/of therapy could result in serious injury or death.
1. To avoid a failure to power up, turn the pump on first, before connecting the pump with the docking
station. This will prevent the failure to power up.
2. To mitigate the potential for an 11/003 error code, remove the External Battery Pack accessory (list #13073) from the Docking Station and pump prior to installing the pump into the Docking
Station. If you use a Docking station in conjunction with an External Battery Pack accessory (list #13073), this practice should not continue. Please contact Hospira to discuss an appropriate alternative option.
3. Inform potential users in your organization of this notification.
4. Should your facility experience a failure to power up or an 11/003 error code, report the issue to Hospira by calling 1-800-441-4100 (M-F, 8am-5pm,CT) or email ProductComplaintsPP@hospira.com.
5. If you have distributed the product further to the retail level, notify your customers that received the product identified above of this notification and ask them to contact Stericycle at 1-
866-792-5451 (M-F, 8am-5pm ET) to receive a reply form.
About Class I Recalls:Class I recalls are the most serious type of recall and involve situations in which there is a reasonable probability that use of these products will cause serious adverse health consequences or death.
Health care professionals and consumers may report adverse reactions or quality problems they experienced using these products to MedWatch: The FDA Safety Information and Adverse Event Reporting Program either online, by regular mail or by FAX.
Additional Resources: 

2014年5月1日 星期四

聯想召修ThinkPad鋰電池

建議各位夥伴,檢查確認一下各醫療儀器是否有搭配讓款筆電,請公司反應原廠...看是否需要處理
-----------------------------
原文出處

原廠網址

行政院消保處昨指出,荷蘭商聯想公司(Lenovo)主動召回ThinkPad筆電專用的鋰離子電池,消費者如有購買聯想於2010年10月到2011年4月產製的ThinkPad筆電,請儘速與該公司聯繫免費置換,該產品在美國已有2起電池過熱導致電腦、電池及周邊財物受損案例,尚無用戶受傷。
消保處指,台灣有販售受影響的筆電包含用於X201、X201s及Edge 13系列電腦電池

  • ThinkPad T410, T420, T510, W510, X100E, X120E, X200, X201, X201s Series
  • Edge 11, Edge 13, and Edge 14 Series
  • Option P/Ns 43R9255, 51J0500, 57Y4186, 57Y4564, 57Y4565, 57Y4625, 57Y4559, 43R9254, 0A36277

總計銷售數量為2137個。聯想客服專線02-87615988。