Evaluating a computerized maintenance management system in a low resource setting

Healthcare and medical equipment sustainability is very important, we need to have an efficient and high performance devices. If such systems or devices are fail every time this will effect patients and the medical system at all. Healthcare equipments like ventilators and other devices nowadays has a good priority and important because of Covid19 which effects all countries now. Since these devices exposed some defects which will effect on its role it is very important to study and analyze such defects, classify them and how to apply CMMS in such maintenance operations. This paper aims to use CMMS in maintenance operations of equipments in healthcare sector. Also a classification of failures of such equipments is generated to be an input for CMMS programs. The second thing is to use Equipment maintenance (EM) number in classifying such devices to be ready for using CMMS. A sample of medical devices are studied and the equipment management number (EM) is calculated here for some selected devices if it reaches some specific value it needs maintenance and CMMS will manage the maintenance operations required. CMMS procedures, transactions and benefits are discussed in this paper. It is found that in the first step we should determine the devices included in inspection and maintenance operations by using EM number, then specifying the maintenance period and inspection frequency after that following some specific steps to manage the maintenance operations followed by CMMS programs. Equipment maintenance (EM) number is very important to determine whether the equipment need maintenance or not, and it also determine the inspection and maintenance duration and so such devices be ready to be used all the time. CMMS can be efficiently used in maintenance operations of healthcare equipments. The use of CMMS software or application is used in processing entered data of devices or systems following the commands step-by-step to construct a CMMS system for each plant or system, this will simplify the monitoring and inspections and maintenance operations which increasing availability of the device and decreasing downtime

In limited resources settings, Health Technology Management (HTM) presents specific challenges, which significantly differ from those faced in higher income settings. In Sub-Saharan Africa (SSA), HTM requires holistic approaches based on reliable information on medical devices operationalized in local medical locations, which may differ significantly from the USA or European ones. Computerized Maintenance Management System (CMMS) tools offer unprecedented opportunities to optimize medical device organization and management in SSA. Nonetheless, CMMS for SSA should be designed to meet real local needs and facing local economic and organizational constraints. This paper describes the results of a project aimed to design and deploy a context-driven CMMS tool, called “GMaint-KM Benin”, which was designed, developed, tested, validated and deployed in the Department of Biomedical Engineering, Ecole Polytechnique d’Abomey-Calavi, University of Abomey-Calavi, Benin. The methods followed to design the CMMS, was inspired by closed-loop control theory. It is based on the idea that an effective CMMS could have been designed using as reference international standards and best practices, while controlling and optimizing CMMS inputs and outputs basing upon information and data measured in Beninese medical locations, following a closed-loop feedback control strategy. The tool is currently fully functional in three Beninese hospitals. The successful method used to design this tool represents a best-practice of optimal co-design for Sub-Saharan Africa, which could be adapted and reused in similar projects aiming to design and deploy health technologies for low-income settings. In perspective, the project aims to enhance “GMaint-KM Benin” and scale it up at the national level. The adoption of such a tool could represent an effective base for comparative studies among African countries.

The Total Productive Maintenance (TPM) approach is one of the main operational strategies to improve production efficiency and reduce maintenance costs. This article reviews the important role of TPM components, especially the Planned Maintenance System (PMS) and Computerized Maintenance Management System (CMMS), in supporting operational performance. The implementation of these systems involves structured data collection and systematic analysis to improve predictive and preventive maintenance. This article also highlights the success factors and obstacles to implementing TPM, PMS, and CMMS, including management commitment, employee training, technology integration, and challenges such as resistance to change and system complexity. The review results show that cross-functional collaboration, a continuous improvement mindset, and the use of advanced technology are the keys to success in optimizing equipment maintenance, reducing downtime, and increasing operational efficiency and cost effectiveness. Across reviewed studies, operational efficiency increased by 12–35% and maintenance costs decreased by 10–30% after adopting TPM, PMS, or CMMS. These findings emphasize the critical role of digital integration and proactive culture in maintenance optimization.

Augmented reality-based computational fieldwork support for equipment operations and maintenance

Among children in low-resource settings, diverse enteropathogens share common, population-level antibody dynamics, which creates a new opportunity to estimate transmission through serologic surveillance.

Accurate diagnosis of infectious diseases is essential for appropriate targeting of treatment and disease control. Rapid diagnostic tests (RDTs) are quick and easy to perform, they give results during one clinic visit, and they can be used in settings with little infrastructure or trained personnel. RDTs are promising tools to improve diagnosis in remote or low-resource settings. In the field of neglected infectious diseases, new manufacturers, RDTs, and users are coming onto the scene [1, 2]. As access to RDTs improves, the need for quality assurance and postmarket surveillance increases. The International Medical Device Regulators Forum has formulated guidelines about quality assurance of medical devices, including RDTs, which have been adopted as regulatory standards in Australia, Canada, the European Union, Japan, and the United States [3]. Specific quality standards for in vitro diagnostic tests (IVDs) (ISO 13485:2003) and medical laboratories (ISO 15189:2012) have been published by the International Organisation for Standardisation [4, 5]. In less-regulated settings, the World Health Organisation (WHO) has stepped in to promote IVD quality [3, 6, 7]. Participation from various stakeholders is required to assure RDT quality. Manufacturers must ensure that their products are ready for the market—i.e., that product design, development, testing, manufacturing, packaging, and labelling meet the required standards of safety and performance. The role of RDT users is, among other responsibilities, to know indications, contraindications, and operating procedures of the devices. Most regulatory authorities recognise that efficient communication between manufacturers and users is key to postmarket surveillance [3–7]. In low-resource settings and in the field of neglected infectious diseases, this communication between manufacturers and users may be suboptimal, as well as the pre- and postmarketing oversight of national regulatory authorities. The Neglected Infectious Diseases dIAGnosis (NIDIAG) consortium aims to improve diagnostic approaches for different clinical syndromes in low-resource settings where neglected infectious diseases are prevalent. In this case study, we assessed several quality aspects of RDTs used in the NIDIAG study about persistent fever: we focused on RDT labelling and instructions for use (IFU) and on product-related incidents, including communication with manufacturers about these incidents.

5 - Commodity Thermoplastics: Polyvinyl Chloride, Polyolefins, Cycloolefins and Polystyrene

Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic. The pre-intervention period was assessed through a retrospective chart review to identify every death and the post-intervention period was assessed prospectively. Interventions consisted of joint obstetrician and hematologist outpatient and acute inpatient reviews, close maternal and fetal surveillance, and simple protocols for management of acute chest syndrome and acute pain episodes. Primary outcomes included maternal and perinatal mortality rates before and after the study period. A total of 158 and 90 pregnant women with SCD were evaluated in the pre- and post- intervention periods, respectively. The maternal mortality rate decreased from 10791 per 100000 live births at pre-intervention to 1176 per 100000 at post-intervention, representing a risk reduction of 89.1% (P = 0.007). Perinatal mortality decreased from 60.8 per 1000 total births at pre-intervention to 23.0 per 1000 at post-intervention, representing a risk reduction of 62.2% (P = 0.20). A multidisciplinary obstetric and hematology team approach can dramatically reduce maternal and perinatal mortality in a low-resource setting.

BackgroundInfections by multidrug-resistant gram-negative bacteria (MDR-GNB) have been continuously growing and pose challenge to health institution globally. Carbapenem-resistant Enterobacteriacea (CRE) was identified as one of the MDR-GNB which has limited treatment options and higher mortality compared to those of sensitive strains. We report an increased burden of CRE fecal carriage at a hospital in the North-eastern region of Malaysia.MethodsA retrospective descriptive study from August 2013 to December 2015 was conducted in the Medical Microbiology & Parasitology laboratory of Hospital Universiti Sains Malaysia, which is a tertiary teaching hospital with more than 700 beds. This hospital treats patients with various medical and surgical conditions. Suspected CRE from any clinical specimens received by the laboratory was identified and confirmed using standard protocols. Polymerase chain reaction (PCR) assay was performed to determine the genotype.ResultsAltogether, 8306 Enterobacteriaceae was isolated from various clinical specimens during the study period and 477/8306 (5.74%) were CRE. Majority of the isolated CRE were Klebsiella [408/477, (85.5%)], of which Klebsiella pneumoniae was the predominant species, 388/408 (95%). CRE were mainly isolated from rectal swab (screening), 235/477 (49.3%); urine, 76/477 (15.9%); blood, 46/477 (9.6%) and about 7.1% from tracheal aspirate. One hundred and thirty-six isolates were subjected to genotype determination and., 112/136 (82.4%) showed positive detection of New Delhi metallo-β-lactamase 1 (NDM-1) gene (blaNDM1).ConclusionThe study noted a high numbers of CRE isolated especially from rectal swabs. Active screening results in significant cost pressures and therefore should be revisited and revised, especially in low resource settings.

<p>Although great strides have been made to tackle hospital-acquired pressure ulcers (HAPUs), there is a need for greater recognition of device-related pressure ulcers (DRPUs), including their causes, management and prevention. This consensus statement, an updated second edition, aims to continue raising awareness of these largely preventable injuries and, crucially, to stimulate action. DRPUs are relatively common and account for a growing proportion of HAPUs. Updated information on the incidence of DRPUs is described in chapter 1. Although it is recognised that DRPUs increase the financial burden of healthcare, there is little formal analysis of their economic impact. This needs to be addressed; robust evidence on the burden of DRPUs and the value that can be released by adopting prevention strategies is needed to help drive action. Our understanding of the pathophysiology of DRPUs has improved significantly over the past few years; this is described in chapter 2. One crucial difference between PUs and DRPUs is that body-weight forces are less significant in DRPUs, with the force being exerted from a device that is typically strapped or taped onto the body. Devices and their securement may generate high stress concentrations in tissues, leading to cell and tissue-damage pathways associated with sustained deformation. As more evidence is published on DRPUs, recurring themes are emerging, as outlined in chapter 3: The most vulnerable patients are bearing the brunt of DRPUs; paediatric and neonatal patients, and all those needing critical care are particularly susceptible. During the COVID-19 pandemic, a new high-risk population (people with severe COVID-19 infection) emerged. They are at increased risk of DRPUs because of their need for prolonged ventilatory support, especially when 'proning' Devices associated with DRPUs are often used to perform essential, life-saving functions. They include continuous positive airway pressure (CPAP) masks or endotracheal tubes. Minimising their use is clearly not an option, so practice innovation is needed Although the most common locations for DRPUs are the face, ears, lower legs and heels, any location where a device comes into close contact with the skin can be at risk. In the same vein, any device, whether needed for a medical purpose or not, has the capacity to cause injury if its use is not properly managed. Vigilance is needed for all patients. What can be done? The importance of routine risk assessment is covered in chapter 4. Although use of a validated risk assessment tool is the vital first step, this will not be enough on its own. Several steps can be taken to ensure the safe use of devices. These are described in chapter 5 and include device repositioning, cushioning with prophylactic dressings and moisture control (only where possible and clinically appropriate). Of key importance is the development of an institutional protocol and champions to ensure all necessary steps are adopted. For any of these changes to be put into practice, awareness of DRPUs needs to increase. A number of proposals are outlined in chapter 6. A change of focus among health professionals and policy makers, along with more investment in education and training, are needed. All patients being managed with a medical device must be considered as at high risk. The pandemic introduced the world to the problem of DRPUs in health professionals caused by the extended wear of personal protective equipment. Health professionals also have a right to expect institutional protocols and provision of devices that protect them from DRPUs. Cutting-edge ideas and technologies that may be available in the future are described in chapter 7. When designing new products, manufacturers of medical devices have a duty of care to investigate the risks of DRPUs associated with their products and mitigate them, wherever possible. Our developing understanding of how the design, structure and materials used in medical devices contribute to DRPUs will help us develop new solutions for tomorrow. The first step is for everyone involved to ask themselves, 'what can I do to help?' There is work to be done-your journey to reduce DRPUs starts here!.</p>

The need for individualized personal care has well-positioned three-dimensional (3D) printing in the health-care industry and the medical applications are expanding rapidly. It is one of the emerging technological frontiers, revolutionizing the medical devices industry by fast-tracking the designing phase, enabling new devices to reach the market faster. Current and potential medical applications of 3D printing include customized implants and prostheses, tissue and organ fabrication, surgical instrumentation, drug delivery and testing systems, and tumor models to understand cancer growth. The benefits include lowering cost for customized applications and easier access for low-income communities and low-resource settings. It is improving patient outcome and quality of life. However, there are also limitations such as regulatory concerns. The promising 3D-printing technology is still in the emerging stage and with improving resolutions of the printed features, its potential is boundless. Here an overview of the advantages of 3D printing is presented for medical devices compared to traditional manufacturing techniques. The future potential and direction for medical applications is discussed along with key challenges.

: Primary postpartum hemorrhage (PPH) is defined as blood loss from the genital tract of 500 mL or more following a normal vaginal delivery (NVD) or 1,000 mL or more following a cesarean section within 24 hours of birth. PPH contributes significantly to maternal morbidity and mortality worldwide. Women can rapidly hemorrhage and die soon after giving birth. It can be a devastating outcome to many young families. Women giving birth in low-resource settings are at a higher risk of death than their counterparts in resource-rich environments. PPH is a leading cause of maternal deaths globally, contributing to a quarter of the deaths annually.Methods: This was a descriptive study carried out at El-Minia Maternity Hospital, a tertiary referral government hospital in a low-resource setting in El-Minia. Data were obtained from the labor ward birth registers for patients who had a diagnosis of PPH during the period from January 1st, 2016 to December 31th, 2017. The cases notes were retrieved and the demographic, clinical and outcome data were gathered. Blood loss was estimated post-delivery by the attending clinician; either a midwife or a doctor. At this maternity unit, blood loss is not measured but estimated owing to prevailing resource constraints. The SPSS Version 21 statistical tool was used to calculate probability values between 2 years. Simple statistical tests were used on absolute numbers to calculate percentages.Results: There were 11057 deliveries at 2016 and 11146 deliveries at 2017 admitted to El-Minia University Maternity Hospital. In the studied groups of patients, there were 201 (1.88%) cases of PPH at 2016 and 189 cases (1.69%) at 2017. About 67.5% at 2016 and 67.7% at 2017 of the cases had NVD. The majority of the cases (77.0%) had an identifi‌able risk factor for developing primary PPH. The most identifiable risk factor for primary PPH was anemia. As regards lines of management, the study noticed that more cases had been explored and undergone hysterectomy in 2017 than in 2016 and this may be according to the severity of cases, general conditions of the patient and other failed medical interventions that pushed decision in this way resulting in decreasing the mortality ratio in 2017 (3.2%) than in 2016 (8.5%) with high significance (P value = 0.027) and survival of most of the cases.Conclusion: The incidence of PPH at El-Minia University Maternity Hospital was (1.88 %) in 2016 and 189 cases (1.69%) in 2017 during the study period, lower than that reported elsewhere in similar setting in the literature. Therefore, this study is important, as it documented for the first time the incidence of the most important causes of global maternal deaths in cases admitted to Maternity Unit, El-Minia University. Future studies should involve the effect on maternal outcomes of PPH. This data can help in mobilizing global efforts to improve women’s health.

Biologic test indicators; classification of medical devices; scope disinfection; reused single-use medical devices

Medical devices and medical disposables contribute significantly to the quality and effectiveness of the health care system. It is necessary to commit scientifically sound regulatory environment that will provide consumers with the best medical care. This includes continued services to small manufacturers, readily available guidance on FDA requirements, predictable and reasonable response times on applications for marketing, and equitable enforcement. But in the public interest, this commitment to the industry must be coupled with a reciprocal commitment: that medical device firms will meet high standards in the design, manufacture, and evaluation of their products. The protections afforded our consumer, and the benefits provided the medical device industry, cannot be underestimated.

The alarming rise in kidnapping incidents across Nigeria demands innovative, reliable, and context-appropriate personal safety solutions. Existing GSM panic buttons and mobile applications are often hindered by hardware constraints, dependence on constant internet connectivity, and slow activation under duress. This paper presents the design and implementation of an anti-kidnapping system that integrates an ESP8266-based emergency button with an Android mobile application, enabling dual-mode alert delivery via Internet or SMS. When the emergency button is pressed, the ESP8266 powers on and instantly enters Wi-Fi Access Point (AP) mode. The Android application, running a foreground service, connects as a client, acquires GPS coordinates from the phone, and combines them with a timestamp and the user’s preconfigured emergency contacts. This information is sent to an IoT server, which triggers notifications via Firebase Cloud Messaging. If internet connectivity is unavailable, the application automatically switches to SMS mode to ensure alert delivery. Hardware-triggered activation and firmware-controlled power-down ensure zero standby power consumption, enabling extended operational readiness on a single charge. Field tests across varying connectivity conditions showed activation in less than 2 seconds, alert delivery in 5–9 s depending on connectivity, and GPS accuracy typically within ±10 m. The system’s low cost, portability, and independence from continuous network access make it suitable for deployment across Nigeria’s urban, rural, and low-resource settings, with potential for broader emergency response applications. Keywords: Anti-Kidnapping Technology, Emergency Alert System, GPS, SMS, Internet-of-Things, Mobile Application