Robert Malkin’s Developing World Healthcare Technology La

Robert Malkin’s


Developing World Healthcare Technology Laboratory


at Duke University




















Biomedical Technician’s Assessment
Instrument Package


June 2016





















Robert Malkin’s


Developing World Healthcare Technology Laboratory


at Duke University



2














The Biomedical Technician’s Assessment Instrument Package includes the foundations of survey


instruments, survey scripts, and reference materials used in the assessment of biomedical technician’s


impact on hospitals in Honduras, Rwanda, and Cambodia. In these studies, impact was defined as the


technician’s ability to decrease out-of-service medical equipment in the hospital. For each assessment,


the instruments were tailored to the specific country program yet the fundamental questions, presented


here, were always included to ensure comparability across countries and years.


Demographic and technical information about the hospital is taken from the hospital, technician, and


hospital administrators. The status of the medical equipment within five departments (operating


theatres, radiology, emergency, maternal and neonatal intensive care, and clinical labs) is reported by


the technician and the head of each department. A work history of corrective maintenance,


preventative maintenance, and management actions were reported by the technicians.


This package includes the instrument and the script for each of the seven fundamental surveys. The


instrument was used during the survey while the script was used as a training tool for each interviewer


and translator. The instrument was translated into the appropriate language and was given to the


interviewee upon request.






















If you need more information or have questions, please get in touch with the Developing World Healthcare Technology


Laboratory at Duke University through sending an email to Dr. Robert Malkin at robert.malkin@duke.edu.




Robert Malkin’s


Developing World Healthcare Technology Laboratory


at Duke University



Table of Contents
Cover Page .................................................................................................................................................... 1


Introduction .................................................................................................................................................. 2


Table of Contents .......................................................................................................................................... 3


Director Survey ............................................................................................................................................. 4


Director Script ............................................................................................................................................... 6


Technician Survey ......................................................................................................................................... 7


Technician Script ......................................................................................................................................... 10


Equipment Survey ....................................................................................................................................... 12


Equipment Script ......................................................................................................................................... 14


Repair Survey .............................................................................................................................................. 20


Repair Script ................................................................................................................................................ 22


Preventative Maintenance Survey .............................................................................................................. 25


Preventative Maintenance Script ............................................................................................................... 28


Management Survey ................................................................................................................................... 30


Management Script..................................................................................................................................... 32


Informal Maintenance Survey..................................................................................................................... 33


Informal Maintenance Script ...................................................................................................................... 34


References .................................................................................................................................................. 37


English Test ............................................................................................................................................. 37


Tool List ................................................................................................................................................... 38


Supply List ............................................................................................................................................... 42


Medical Equipment List ........................................................................................................................... 43


Biomedical Technician’s Assistant Skill List ............................................................................................. 44







Robert Malkin’s Director Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University


Hospital: Date:
4


We are from Duke University which is partners with Engineering World Health (EWH) and the GE Foundation. EWH is a nonprofit
that works on improving health around the world through biomedical engineering. We have training courses in Rwanda, Honduras,
Nigeria, Ghana, & Cambodia. Our purpose in conducting this assessment of hospitals is to better understand if our programs are
appropriate and helpful. We will be conducting this assessment at your hospital over the following two days. During this time, we
hope to do three things. 1) Speak to you for approximately 45 minutes 2) Speak to the hospital technicians and see their workshop
and 3) Survey the hospital’s medical equipment in five departments. We want to look at equipment in the Operating Room, Clinical
Laboratory, Imaging, Neonatal and Maternity, and Emergency Room. We would like to ask for your permission to conduct this work
in your hospital for the next two days.


Position Name Phone Number Email Years at Hospital







Script Form


General Information
1. What population does your hospital serve? (# of people)?
2. How many beds are in your hospital?
3. What is your usual occupancy rate? (% of beds filled on average)
4. How many inpatients does your hospital see in a year?
5. How many outpatients does your hospital see in a year?
6. How many operating rooms are in use?
7. How many ICU beds does your hospital have?


General Information
1. Population Served:
2. # of Beds:
3. Occupancy rate:
4. Inpatients:
5. Outpatients:
6. # OR:
7. # ICU Beds:


Equipment Information
8. What % of your equipment do you estimate is donated?
9. What % of your equipment do you estimate is in service?
10. Did your hospital buy any medical equipment in the last 12


months?
11. Do you have a log of purchased equipment you have bought? May


I see the log? May I take a picture of this log?
12. Does your hospital have money set aside each year to spend on


equipment? If yes, how much?
May I see the budget? May I take a picture of the budget?
13. Does your hospital have money set aside each year to spend on


spare parts and accessories? If yes, how much?
14. Over the past 12 months, how much money has been spent on


spare parts and accessories?
15. Who approves the order of the spare parts and accessories?
16. Who orders the spare parts and accessories?
17. How many times in the last month was a request for spare parts


and accessories approved?
18. Does the hospital maintain an inventory of medical equipment?


May I see the inventory? May I take a picture of the inventory?


Equipment Information
8. % Donated:
9. % in service:
10. Bought: Y / N

11. Log: Y / N



12. Equipment Budget: None,  _______





13. Components Budget: None,  _______


14. Money spent:

15. Who approves:
16. Who orders:
17. # times:



18. Inventory: Y / N





Interaction with Technician
19. How many medical equipment technicians are there at the


hospital? (technician = anybody who repairs medical equipment)
20. Do you have a regular meeting with the technicians?
21. How often do you talk with your technician?
22. What topics do you most commonly talk about with the


technician?


Interaction with Technician


19. # Techs:




20. Regular meeting: Y/ N


21. How often:


22. Topics:




Robert Malkin’s Director Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University


Hospital: Date:
5


Technician Satisfaction
23. When was the last time you hired a technician?
24. When was the last time you fired a technician?
25. When was the last time a technician was promoted? Why were


they promoted?
o What increased responsibilities result from promotion?


26. Has overall number of technicians increased, decreased, or stayed
the same in the last five years? By how many technicians has the
overall number changed?


Technician Satisfaction
23. Technician hired:
24. Technician fired:
25. Promoted:


Why:
Increased responsibilities:


26. Change in number: Increased/Decreased/Stay
Same
How many:


Reporting
27. Does your technician provide you any written reports?
28. What was the date of the last report you received?
29. What do you use the information in reports for?


Reporting
27. Tech provides reports Y/ N
28. Date:
29. Use:


Presence of other programs/NGOs
30. Which aid organizations (NGO or governmental) donate medical


equipment to your hospital?
31. Which aid organizations (NGO or governmental) provide training


on medical equipment?
32. In the last 12 months, how many pieces would estimate you have


received?
33. In the last four years, how many pieces would you estimate you


have received?


Presence of Other Programs/NGOs


30. Donate Equipment:




31. Provide Training:


32. Last year:




33. Last four years:


Service Contractors/ Service Providers
34. Does the MOH provide service contracts for any equipment?
35. Does the hospital negotiate for service contracts for any


equipment?
36. Does your hospital use fee for service / one time providers?
If yes to SC probe on:
37. Are parts, accessories, & consumables included in the contract?
38. What are the names of the service contractors? What equipment


do they work on?





39. Who negotiates and signs the contract? (list title, department)
If yes to fee for service probe on:
40. What is the budget for fee for service?
41. How many times in the 12 months have you contact a fee for


service technician?
42. Has this changed over the four years?


Service Contractors/ Service Providers


34. Use MOH SC? Y / N / Don’t Know


35. Use Hospital SC? Y / N / Don’t Know




36. Fee for service? Y / N / Don’t Know


37. Parts: Y / N / Don’t Know


38.


Names Types








39. Who:


40. Budget:


41. Last year:




42. Changed:




Robert Malkin’s Director Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



6




Purpose: The Director Survey allows the research team to be formally introduced to the hospital administration, gain


demographic information about the hospital, understand the level of involvement the administration has with the


hospital technicians, and confirm previously granted permission to conduct the research.


Required Participants:


Two members of the research team


Director (if the Director is not available, then this survey may be conducted with the sub-director)


Translator


Optional Participants:


Sub-Director


Head of Maintenance, or someone who is aware of the procedure for purchasing medical equipment


Administrator, or someone who is aware of basic hospital statistics (inpatients, outpatients, etc.)


Technician


Reference Documents: There are no reference documents needed for this instrument.


Allotted Time: 45 Minutes – 1 Hour


Method: This is an interview-assisted survey. One member of the research team will be responsible for asking the


questions via the Director Survey to the participants. The second member of the research team will be responsible for


recording the participants’ responses and collecting/taking pictures of any physical documents presented during the


meeting. This instrument can be sent over to the Director’s office in advance. It is not unlikely for the Director to


unaware of some of these questions; therefore, if the instrument is sent over prior to the meeting, the hospital can


arrange for the appropriate and informed administrators to be a part of the meeting.


1. Start the meeting with an introduction of the research participants and an exchange of business cards. Then inform


the participants of the purpose of the research study, the specific actions the research team will perform over the


following days, the amount of time needed with the Director, and verbal confirmation of the Director’s permission


for this research to be conducted in the hospital.


2. Record the position, name, phone number, email address, and number of years at the hospital of each participant.


At the minimum, the Director information will be recorded. If the technician attends this interview, it is not


necessary to obtain his information at this time as the information will be recorded in the Technician Survey.


3. Interview the Director according the left hand side of the Director Survey labeled “Script”


4. Record the participant’s responses on the right hand side of the Director Survey labeled “Form”


 Anytime this symbol [ ] is present, circle the if the research team has seen the requested document


 Anytime this symbol [ ] is present, circle the if the research team took a picture or scanned the requested


document





Robert Malkin’s Technician Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



Hospital: Date:
7




We are from Duke University which partners with Engineering World Health (EWH) and the GE Foundation. EWH is a nonprofit that
works on improving health around the world through biomedical engineering. We have training courses in Rwanda, Honduras,
Nigeria, Ghana, and Cambodia. We will be conducting an assessment at your hospital over the following two days. During this time,
we will spend the majority of our time with you and your biomedical department. First, we would like to ask you questions about
your role as biomedical technician. This survey will take approximately 45 minutes, is that okay with you?


-----------------------Speak to every person who works in the maintenance or biomedical department (if more than one continue on
back)---------------


Introduction
1. What is your name?
2. What is your email address?
3. What is your phone number?
4. How many years have you worked at this hospital?
5. What is your job title?
6. Did you attend the EWH program?
7. Have you had any previous BMET Training? If yes, ask the technician to


describe their previous trainings.
8. What languages do you speak?
9. Do you speak English? If yes, please give the technician the English test


and record appropriately.
10. Did you graduate from high school?
11. Did you graduate from Technical School? What was your major?
12. Did you graduate from University? What was your major?
13. Did you attend any other forms of education? If yes, please ask the


technician to describe that form of education.


Introduction
1. Name:
2. Email Address:
3. Phone Number:
4. Years:
5. Title:
6. EWH: Y / N
7. BMET Training: Y / N
Description:
8. Languages:
9. English: Y / N
Test Score:
10. High School: Y / N
11. Technical School: Y / N Major:
12. University: Y / N Major:
13. Other: Y / N
Description:


-----------------------Talk to the lead technician and other technicians that are responsible for repairs and maintenance in the
maintenance department -----------------------


Parts
14. When you are repairing medical equipment and you need a replacement


part, how do you get the replacement parts?
15. Where do you get the spare parts you need?
16. Do you have any paperwork?


May I see a copy? May I take a picture?
17. Who do you have to request the part from?
18. When was the last time you requested a spare part?
19. How long did it take you to receive it?
20. Do you feel you are able to get the parts you need?
21. What are the barriers to getting the parts you need?
22. Do you have a room or cabinet of spare parts at the hospital?


May I see a copy? May I take a picture?
23. What part of the budget does money for spare parts come from?


Parts


14. How:

15. Where:
16. Parts acquisition paperwork? Y / N



17. Who request:
18. Last request:
19. Wait time:
20. Able to get parts: Y / N
21. Barriers to parts:
22. Parts storage: Y / N



23. Parts budget:


Hospital Hierarchy
24. Who is your boss? Who is that person’s boss? (continue until director to


draw hierarchy)

25. Do you provide any reports to the hospital administration? May I see a


copy? May I take a picture of the reports?


Hospital Hierarchy



Tech
25. Reports to administration? Y / N





Robert Malkin’s Technician Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



Hospital: Date:
8




Effort percentage
26. What percentage of your time do you spend working on facilities issues


(electricity, water, air conditioning)?
27. What percentage of your time do you spend working on medical


equipment?
28. Of the time you work on medical equipment, what percentage is on


repairs?
29. Of the time you work on medical equipment, what percentage is on


preventative maintenance?
30. Of the time you work on medical equipment, what percentage is on


management actions (paperwork, work tickets, reports)?
31. What are the other responsibilities you have at the hospital?
32. What percentage of your time do you spend on these other


responsibilities?
33. Are there any types of equipment you are not allowed to work on?
34. Are there any departments that you are not allowed to work in?
35. Are there any types of equipment you choose not to work on?


Effort Percentage Tech 1
26. Facilities:

27. Equipment:

28. Repairs:

29. Maintenance:



30. Paperwork:



31. Other Resp:
32. % Other Resp:

33. Allowed:



34. Departments:
35. Choose:


Tech 2


Service Contractors/ Service Providers
36. Does the Ministry of Health provide service contracts for any medical


equipment?
37. Does the hospital negotiate for service contracts for any medical


equipment?
38. Does your hospital use fee for service one time providers?
If yes to SC probe on:
39. Are parts, accessories, & consumables included in the contract?
40. What are the names of the service contractors? What equipment do


they work on?


41. Who negotiates and signs the contract? (list title, department)
If yes to fee for service probe on:
42. What is the budget for fee for service?
43. How many times in the last year have you contact a fee for service


technician?
44. Has the number of times the hospital contacted a fee for service


technician increased, decreased, or stayed the same over the past four
years? Why?


Service contract


36. Use MOH SC? Y / N / Don’t Know


37. Use Hospital SC? Y / N / Don’t Know


38. Fee for service? Y / N / Don’t Know

39. Parts: Y / N/ Don’t Know
40.


Names Types






41. Who:

42. Budget:
43. Last year:

44. Changed: Increase/Stay Same/Decrease


Why:


Shop Which of the following tools do you have? 36-42: How often do you use it (D W M)?
 1  6  11  16  21  26  31  36  41 ____
 2  7  12  17  22  27  32  37 ____  42 ____
 3  8  13  18  23  28  33  38 ____  43
 4  9  14  19  24  29  34  39 ____
 5  10  15  20  25  30  35  40 ____
May we take see your workshop and your tools? May we take a picture of your shop?
Shop condition:


Supplies: How often are you able to get these items for the repairs you need: Always (A), Often (O), Rarely ( R ),Never (N)




Robert Malkin’s Technician Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



Hospital: Date:
9




 1______  4______  7_______  10_______  13_______  16_______  19_______  22_______
 2______  5______  8_______  11_______  14_______  17_______  20_______  23_______
 3______  6______  9_______  12_______  15_______  18_______  21_______  24_______


Interaction with Director
45. How often do you meet with the director?
46. What topics do you typically discuss?


Interaction with Director
45. Interactions:
46. Topics:


Requests for technical assistance
47. In the last 12 months, who did you contact when you needed assistance


with a repair?
Name: What is the name of the company or the person’s name who you
contacted? (Other technicians, regional repair unit, foreign support,
outside repair agency, service contractors)
Time: How many times did you contact this person in the past 12
months?
Mode: How did you contact this person? (Phone call, email, face to face,
facebook)
In/Out: Was the person located inside or outside of the country?


Requests for technical assistance


Name # times Mode In/Out


1.


2.


3.


4.


5.


6.


7.


8.


Incoming Equipment & Tech Status
48. Who purchases medical equipment at the hospital? Are you involved


when a piece of equipment is purchased?
49. Is incoming equipment recorded?


May I see a copy? May I take a picture of this record?
50. Who accepts incoming equipment? (title and department) Are you


involved?
51. Who installs incoming equipment? (title and department) Are you


involved?
52. Who trains users on how to use the equipment? (title and department)


Are you involved?
53. Where do you keep the medical equipment manuals?
54. How many do you have?


May I see the manuals? May I take a photo of the manuals?


Incoming Equipment & Tech Status
48. Purchased by:


Tech involved: Y / N
49. Recorded? Y / N



50. Received by :


Tech involved: Y / N
51. Installed by: _


Tech involved: Y / N
52. User training by:


Tech involved: Y / N
53. Manuals placed:
54. Number of Manuals:



Workflow – Fill out work tickets
55. When a piece of equipment is broken, which person lets you know that


it is broken?
56. How does this person let you know?
57. Do you have any paperwork for the request?


May I see a copy? May I take a picture of the paperwork?
58. (If 2+ tech) After you know a piece of equipment needs repair, how do


you decide who repairs it?

59. Do you record the repairs you make?


May I see a copy? May I take a picture of the repairs?


Workflow


55. Who:


56. How:
57. Request Paperwork: Y / N



58. Delegation if more than one tech:


Whoever available Head Tech By
Specialty


59. Repair Paperwork: Y/ N






Robert Malkin’s Technician Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



10




Purpose: The Technician Survey allows the research team to gain information about the technician’s educational


background, the proportion of the technician’s time spent working on medical equipment, relationship between the


technician and the administration, and how the technician acquired spare parts and accessories needed for medical


equipment.


Required Participants:


Two members of the research team


Translator


Technician


Reference Documents:


English Test


Tool List


Supply List


Allotted Time: 45 Minutes – 1 Hour


Method: This is an interview-assisted survey. One member of the research team will be responsible for asking the


questions via the Technician Survey to the technician. The second member of the research team will be responsible for


recording the participants’ responses and collecting/taking pictures of any physical documents presented during the


meeting.


1. If the technician was not a part of the Director meeting, then start the meeting with an introduction of the research


participants and inform the participants of the purpose of the research study.


2. Interview the technicians according the left hand side of the Technician Survey labeled “Script”


3. Record the participant’s responses on the right hand side of the Technician Survey labeled “Form”


 Anytime this symbol [ ] is present, circle the if the research team has seen the requested document


 Anytime this symbol [ ] is present, circle the if the research team took a picture or scanned the


requested document


4. For question 9, use the “English Test” Reference Sheet. If the technician reported that he/she can speak English,


then give the technician the English Test. The technician will need to do read and response to the three questions


provided. For every question the technician answers correctly, the technician will be allotted one point. Therefore,


the final score will be out of 3 points


5. For question 24, create a flow chart of the hospital hierarchy. See the example below:







Robert Malkin’s Technician Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



11


6. For the section titled “Shop”, use the “Tool List” Reference Sheet. Hand the reference sheet to the technician. One


researcher can guide the technician through the reference sheet inquiring if the technician has each tool. The other


researcher will only check the corresponding box if the technician has positively identified having the tool. For tools


36-42, if the technician identifies having the tool, the researcher needs to ask if the technician uses that tool daily,


weekly, or monthly. The second researcher will record either a D for daily, W for weekly, or M for monthly next to


tools 36-42. The name of each tool should be translated and placed on the yellow part of the reference sheet prior


to the technician interview.


 The researchers should take photos of the workshop space. These pictures should include but is not limited


to medical equipment being stored/repaired in the workshop, tools, spare parts and accessories, computer,


and manuals.


7. For the section titled “Supplies”, use the “Supply List” Reference Sheet. Hand the reference sheet to the technician.


One researcher can guide the technician through each supply and inquire if the technician has access to that each


supply Always, Often, Rarely, or Never. The name of each supply should be translated and placed on the yellow part


of the reference sheet prior to the technician interview.


8. For question 47, list each person or company the technician reached out to for help over the past 12 months. For


each person/company listed, record the number of times the technician contacted the person/company, how the


technician contacted them, and if the person/company was located inside or outside the country.





Robert Malkin’s Equipment Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University


Hospital: Date:
12




Equip #


__1
Type: Manf and H#: Problem:


Dept: Source:


D P L
Name of Source: Time in Hospital:


yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__2
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__3
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__4
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__5
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other




Robert Malkin’s Equipment Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University


Hospital: Date:
13




Equip #


__6
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__7
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__8
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__9
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other


Equip #


__0
Type: Manf and H#: Problem:


Dept: Source:
D P L


Name of Source: Time in Hospital:
yrs


Down:


d m y
NU: R NU NCN NUT D
Other:


Room # &
Description:




Fixer:


I O B N
War / Cont / FFS
Name:


Status:


F PF

NF NU



PPM / R
/ MANG


TO: UO: SCO:


Have it: CNIP / time / money / Not available locally / Have it
How long: Single Use / Many Patients / Lifetime
From: LM / Capital / MOH / Intl / Other





Robert Malkin’s Equipment Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



14






Purpose: The Equipment Survey allows the research team to document the amount of functional equipment in each of


the five visited departments. Furthermore, this survey allows the research team to understand the barriers the


technician faces to repairing the partially and non-functional equipment.


Required Participants:


Two members of the research team


Translator


Technician


User- someone from the department that is a primary user of the medical equipment, typically this is the head


of the department




Reference Documents:


Medical Equipment List


Allotted Time: 5 hours


Method: This is an interview-assisted survey. One member of the research team will be responsible for asking the


questions via the Equipment Survey Script and recording the participants’ response. The other research team member


will be responsible for identifying all the medical equipment in each department and taking pictures. The pictures should


include the medical equipment, serial number, hospital inventory number, and any donation labels. If the piece of


medical equipment is hooked up to a patient, the patient must not be included in any of the pictures.


This survey needs to be completed for each piece of equipment in five departments:


Clinical Labs: Any room or hospital section where patient samples are analyzed


Operating Theaters: Any room or hospital section where surgery takes place with general anesthesia. A procedure


room where surgery is performed under local or no anesthesia will not be included.


Radiology: Any room or hospital section where medical imaging takes place


Maternity and Neonatal: Any room or hospital section providing care for pregnant women before, during or after


childbirth, including infant nurseries. The neonatal department is any room or hospital section where babies 28 days


old or less are treated


Emergency Room: Any room or hospital section meant to treat patients who require rapid treatment




1. The technician and the research team will go visit the first department and identify the head of the department.


Introduce the research team and the procedure for this survey to the head of the department.


Say: “We are from Duke University which is partners with Engineering World Health and the GE Foundation. We are


here to do a survey of all the medical equipment in your department. We would like ask you a few questions about


each piece of equipment and take pictures of the equipment. This survey will take approximately 1 hour. Do you


have any questions we can answer before we start the survey?”


2. Identify the first piece of medical equipment that will be surveyed.


3. Create a unique number for each piece of medical equipment. Write this number in the “Equip #” box.


4. Write down which department the medical equipment is located in the “Dept” box.




Robert Malkin’s Equipment Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



15




5. Assign each room visited in the department a new room number. Write this room number and a short description of


the room in the “Room # & Description” box.


6. Refer to the Medical Equipment List and write down the corresponding acronym in the “Type” box.


7. If the name of the manufacture and the hospital inventory number are visible, write this information in the “Manf


and H#” box.


8. The researcher now needs to identify the source of the medical equipment. This question should be answered by


the user of the medical equipment.


Say: “Was this piece of medical equipment donated, purchased, or loaned?”


Circle donate (“D”), purchased (“P”), or loaned (“L”), according to the user’s response, in the “Source” box.


If the user identified that the piece of equipment was donated, then the researcher needs to identify which


company donated the equipment.


Say: “Which company donated this piece of equipment?”


Write down this response in the “Name of Source” box.


If the user identified that the piece of equipment was purchased, then the researcher should write Hospital in the


“Name of Source” box.


If the user identified that the pieced of equipment was loaned, then the researcher needs to identify which company


has loaned the equipment to the hospital.


Say: “Which company loaned this piece of equipment?”


Write down this response in the “Name of Source” box.


9. The researcher now needs to identify who is responsible to perform preventative and corrective maintenance on


this piece of medical equipment. This question should be answered by the user of the medical equipment.


Say: “Who is responsible for fixing this piece of equipment?”


If the user responds that it is the in-house technician, then circle the “I” in the “Fixer” box. Skip to step 11.


If the user responds that it is an outside technician, then circle the “O” in the “Fixer” box.


If the user responds that it is both the in-house technician and the outside technician, then circle the “B” in the


“Fixer” box.


If the user responds that no one is responsible for the equipment, then circle the “N” in the “Fixer” box. Skip to step


11.


10. The researcher now needs to identify if the piece of equipment is still under warranty, if there is a service contract


for the piece of equipment, or if the hospital pays fee for service to repair this piece of equipment.


Say: “Is this piece of medical equipment under warranty, service contract, or do you use fee for service?”


Circle the warranty (“War”), service contract (“Cont”), or fees for service (“FFS”) in the “War/Cont/FFS” box.




Robert Malkin’s Equipment Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



16




Say: “Which company is responsible for the [warranty, service contract, fee for service]?”


Write this response next to the Name in the “War/Cont/FFS” box.


11. The researcher need to identify how long the piece of medical equipment has been in the hospital.


Say: “How long have you had this piece of equipment?”




Write this time down in the “Time in Hospital” box.




12. The researcher needs to identify the current status of the piece of medical equipment. Refer to the definitions


below.




Functional: Any equipment that had been used in the last six months and is described as fully functional from


the user


Partially functional: Any equipment that was being used but did not have all the clinical functions needed as


defined by the user


Not Functional: Any equipment that could not be used on patients or had not been used in the last six months


but the user considered it clinically necessary and wanted it to be repaired


Not Used: Any equipment that was not being used on patients or had not been used in the last six months and


which will not be repaired. Equipment in this category was assigned an additional status of retired, never used,


no user training, not clinically needed, duplicate, or other.




Use the below flow chart in order to determine which questions to ask the user and to identify how the final status


of the piece of equipment will be categorized.






Circle the appropriate functional (“F”), partially functional (“PF”), not functional (“NF”), or not used (“NU”) in the


“Status” box.




Robert Malkin’s Equipment Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



17




13. If the user responded that the status was partially functional or not functional, the researcher needs to identify the


problem, the amount of time the equipment has been down, and the obstacles. If the user responded that the


status was functional or not used, proceed directly to step 14.


Say: “Why isn’t this piece of equipment fully functional?”


Write down the response in the “Problem” box.


Say: “How long has this piece of equipment not been fully functional?”


Write down the response in the “Down” box.


Say to the technician: “Why haven’t you repaired this piece of equipment?”


Categorize the technician’s response into one or more of the following:


0: The user told me he/she does not need it to treat patients


1: I didn’t know it was broken


2: I know it’s broken, but I haven’t looked at it yet


3: I need training on repairing this equipment


4: I don’t have the authority to touch it. I need permission


5: I don’t have the tools that I need


6: I don’t have the components (spare parts, accessories, supplies) needed


Write down the corresponding number in the “TO” box. If the technician answered number 6, then the researcher


needs to identify why the technician does not have the components available. If the technician did not answer


number 6, then skip this section and proceed to the section beginning with “Say to the user”.


Say to the technician (if responded that number 6 was an obstacle): “Why don’t you have the component you


need?”


Categorize the technician’s response into at least one of the following:


CNIP: I don’t know how to identify the component


Time: I have not had time to install the component


Money: The hospital does not have money for the component


Not Available Locally: The component is not available locally


Have it: I have the component


Circle the appropriate category in the “Have it” box.


Say to the technician (if responded that number 6 was an obstacle): “How long should this component last?”


Categorize the technician’s response into one of the following:


Single Use: This component should only be used for one patient and then another one would be needed.


Many Patients: This component should be expected to be replaced regularly throughout the lifetime of


the piece of equipment


Lifetime: This component should be expected to last the lifetime of the equipment.




Robert Malkin’s Equipment Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



18




Circle the appropriate category next to the “How Long” Section in the “Have it” box.


Say to the technician (if responded that number 6 was an obstacle): “Where is the component available?”


Categorize the technician’s response into one of the following:


LM: In the local market


Capital: In the capital city


MOH: Through the Ministry of Health


Intl: Through an international source


Other: A different place than any of the above categories


Circle the appropriate category next to the “From” Section in the “Have it” box.


Say to the user: “Why aren’t you using this piece of medical equipment?”


Categorize the user’s response into at least one of the following categories:


1: I don’t have the necessary user training


2: I don’t have the components (spare parts, supplies, accessories) the equipment needs.


3: I need to tell the technician/biomedical department to come repair this equipment or provide user training


4: I have already requested that the technician/biomedical department come repair this equipment or provide


user training.


Write the corresponding number to the user’s response in the “UO” box.


If the piece of medical equipment is under a service contract, say to the technician: “Why hasn’t the service


contractor repaired this piece of medical equipment?”


Categorize the response into at least one of the following categories:


A: I have not called the service contract provider


A1: Because I do not have the authority to call the service provider


B: I don’t know what is covered by the service contract and/or who the contract is with


C: I have called the service contract provider but they have not come yet or are not responding helpfully


D: I have called the service contract provider but they have come and were unable to fix the equipment


D1: Because they were unable to obtain the necessary spare part


D2: Because they could not diagnose the problem with the machine


E: The service contract does not cover the needed spare part, accessory, or consumable needed to return the


equipment to service


Write the corresponding letter and number to the technician’s response in the “SCO” box.


14. If the status of the medical equipment was reported as “Not Used”, then the researcher needs to identify why the


piece of equipment is not used.


Say: “What is this piece of medical equipment not used?”


Categorize the user’s response into one of the following categories:




Robert Malkin’s Equipment Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



19




R: Retired


NU: Never Used


NCN: Not clinically needed


NUT: No user training


D: Duplicate but fully functional


Other: A different reason that the equipment is not used


15. The second researcher needs to take a picture of the unique Equipment number on the Equipment Survey. Then


take a picture of the medical equipment, serial number, hospital inventory number, and any donation stickers on the


medical equipment.


16. Repeat steps 2-15 for each piece of medical equipment in the department.


17. Repeat steps 1-16 for the each of the five departments.




Robert Malkin’s Repair Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University




Hospital: Date:
20


Case #: __1
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __2
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __3
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __4
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __5
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved




Robert Malkin’s Repair Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University




Hospital: Date:
21


Case #: __6
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __7
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __8
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __9
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved


Case #: __0
Problem: Date Began:


_____ / 201___
Assistance? N / Y Who?
Phone Email F to F


Internet? N / Y Opened? N / Y
Equip Type: What they did:



Parts: Single Use / Many Patients / Lifetime


Type Part:


# of pieces: Where stocked: L / MOH / Int /Capital


Paperwork: Y / N BTA skills: Repair Time: d m y
Resolved: Fully / Partially / Unresolved




Robert Malkin’s Repair Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University




Hospital: Date:
22





Robert Malkin’s Repair Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



22




Purpose: The Repair Survey allows the research team to gain information about the number of times the technicians


perform corrective maintenance on the medical equipment in the hospital. This sheet records the details of repairs


including the date of the repair, the problem addressed, if outside assistance was used, and how long it took for the


technician to perform the repair.


Required Participants:


One member of the research team


Translator


Technician


Reference Documents:


BTA Skills


Allotted Time: 1 hour


Method: This is an interview-assisted survey. One member of the research team will be responsible for asking the


questions via the Repair Survey Script and recording the participants’ response.


1. Introduce the technician to the next survey.


Say: “In this next survey, we will be asking you questions about the number of times you have performed repairs


over the past 12 months. This sheet will take approximately 1 hour. Before we start this survey, please gather all the


paper documentation you have for the repairs.”


2. It is important to identify the repairs in a systematic manner. Typically, it is best to go through the technician’s


paperwork and discuss each repair individually. After the research team has discussed each paperwork repair, then


the research team should probe the technician if they completed any other repairs in the past 12 months. It can be


helpful for the research team to use the Medical Equipment List to ensure that they have asked about each type of


medical equipment.


3. The researcher needs to create a case number for each identified repair. In the upper left box, the technician can


write the correct case number.


4. The researcher now needs to identify the type of medical equipment the technician repaired.


Say: “What type of medical did you repair?”


Write the type of medical equipment in the box labelled “Equip Type”.


5. The research will now identify the number of pieces that were repaired at the same time. If the repair is completed


on a separate date, then the repairs would be considered separate cases.


Say: “How many pieces of that type of equipment did you repair during that one instance?”


Write the number of reported pieces of equipment in the “# of pieces” box.


6. If the technician is referencing completed paperwork to discuss this repair, the researcher needs to circle the Y in


the “Paperwork” box. The research team will need to take a picture or scan all repair paperwork. If the technician is


using their memory to report this repair, then the researcher needs to circle the N in the “Paperwork” box.




Robert Malkin’s Repair Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



23


7. The researcher will now identify the problem with the medical equipment.


Say: “For this repair, what was the reported problem with the piece of medical equipment?”


Write down the reported issues in the “Problem box”.


8. The researcher needs to identify how the technician repaired the medical equipment.


Say: “What steps did you take in order to repair the medical equipment?”


Write down the description of the technician’s repair process in the “What they did” box.


9. The technician needs to use the BTA Reference Sheet to identify any BTA skills that the technician performed. It is


the responsibility of the research team to identify the BTA skills while the technician described how a piece of


medical equipment was repaired. Then the technician needs to write down the appropriate BTA skill numbers in the


“BTA skills” box.


10. If the technician identified the use of a spare part during the repair process, the researcher should write down the


identified spare parts in the “Type Part” box. If the technician did not identify a spare part during the repair process,


then skip to step 13.


11. The research team then needs to ask the technician if the spare part will be used for one patient (“Single Use”),


many patients (“Many Patients”), or the lifetime (“Lifetime”) of the medical equipment. The researcher needs to


circle the appropriate lifetime of the spare parts in the “Parts” box.


12. The research team needs to identify where the technician got the spare parts.


Say: “Where do you go to obtain this spare part?”


The research team will then need to categorize the technician’s response into at least one of these four categories:


local market (“L”), ministry of health (“MOH”), international market or online (“Int”), a market in the capital city


(“Capital”). Then the researcher will circle the appropriate location of the spare part in the “Where stocked” box.


13. The researcher will now identify which month and year the repair was conducted. Write the month and year in the


“Date Began” box.


14. The researcher needs to identify if the technician had assistance completing the repair.


Say: “Did you have any assistance to complete this repair?”


If the technician responds in the negative, circle the N in the “Assistance” box and proceed to step 15.


If the technician responds in the affirmative, circle the Y in the “Assistance” box.


Say: “Who was the person who helped you with the repair?”


Write the name of this person or company next to Who in the “Assistance” box.


Say: “How did you contact this person or company?”


The researcher will need to categorize the technician’s response into one of three categories: text or phone call


(“Phone”), website or email (“Email”), or face to face (“F to F”). Then the researcher will circle the appropriate way


of contacting assistance in the “Assistance” box.




Robert Malkin’s Repair Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



24


15. The researcher will now identify if the technician used the internet during the repair process.


Say: “Did you use any websites or other sources on the internet to complete this repair?”


If the technician responds in the negative, then circle the N in the “Internet” box. If the technician responds in the


affirmative, then circle the Y in the “Internet” box.


16. The researcher will now identify if the technician opened up the piece of medical equipment during the repair.


Say: “Did you open this piece of medical equipment during the repair process?”


If the technician responds in the negative, then circle the N in the “Opened” box. If the technician responds in the


affirmative, then circle the Y in the “Opened” box.


17. The researcher will now identify how long it took for the technician to repair the piece of equipment. The repair


time should begin when the technician became aware of the status of the medical equipment. The repair time


should end when the technician either repaired the equipment or concluded that the piece of equipment could not


be repaired.


Say: “How long did it take you to repair this piece of equipment from the time you became aware of the problem to


when you fixed the equipment?”


Write this reported time down in the “Repair Time” box. Then circle days (“d”), months (“m”), or years (“y”) to


specific how long it took the technician to repair the equipment.


18. The researcher will now identify the ending status of the medical equipment.


Say: “Is the medical equipment now fully functional, partially functional, or non-functional?”


Categorize and circle the technician’s response into fully functional (“Fully”), partially functional (“Partially”), or non-


functional (“Unresolved”) in the “Resolved” box.


19. Repeat steps 3- 18 until the researcher and the technician has discussed each repair the technician has conducted in


the past 12 months.




Robert Malkin’s Preventative Maintenance


Developing World Healthcare Technology Laboratory BMET Assessment
at Duke University


Hospital: Date:
25




In this next survey, we will be asking you questions about the number of times you have performed planned
preventative maintenance over the past 12 months. This sheet will take approximately 30 minutes. Before we start
this survey, please gather all the paper documentation you have for preventative maintenance actions.


Script Form


General Information
1. Do you have paper documentation for preventative maintenance?



2. Do you have a schedule for the preventative maintenance you


perform?


3. How often are you not able to complete the scheduled
preventative maintenance?




4. What percentage of PPM are you eventually able to complete?
5. How many days delay does it take for you to complete the


preventative maintenance?
6. What barriers to performing preventative maintenance do you


face to complete it as scheduled?


General Information
1. PPM: Y / N



2. Perform: Y / N



3. Not Able:



4. % Unable:
5. Days Delay:



6. Barriers:
















Robert Malkin’s Preventative Maintenance


Developing World Healthcare Technology Laboratory BMET Assessment
at Duke University


Hospital: Date:
26




Equipment
Type


Memory /
Paperwork


Times Completed /
Times Planned


# worked
on


Contact anyone
for assistance


Open the
machine


Clean the
machine


Calibrate
Use any


parts
What did you do? [describe, list, info from other questions]


PAMO M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:




SUMA M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


OXCO M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


AUCL M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


OPTA M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


ESUM M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


ANMA M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


XRAY M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


ULTR M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


REFR M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:


MICS M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:




DFIB M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:





PHLI M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:




Robert Malkin’s Preventative Maintenance


Developing World Healthcare Technology Laboratory BMET Assessment
at Duke University


Hospital: Date:
27




Equipment
Type


Memory /
Paperwork


Times Completed
/ Times Planned


# worked
on


Contact anyone
for assistance


Open the
machine


Clean the
machine


Calibrate Use any
parts


What did you do? [describe, list, info from other questions]


CENTR M / P /
Y N


Who:
Y N Y N Y N Y N


Parts:




ECGR M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


VENT M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


WABA M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


HEAN M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


ORLI M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


ININ M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


INFW M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


BPMA M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


CLOV/LAIN M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:


NEBU M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:




FEMD M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:





FLPU M / P
/ Y N


Who:
Y N Y N Y N Y N


Parts:




Robert Malkin’s Preventative Maintenance


Developing World Healthcare Technology Laboratory BMET Assessment
at Duke University


Hospital: Date:
28





Robert Malkin’s Preventative Maintenance Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



28




Purpose: The Preventative Maintenance Sheet allows the research team to gain information about the number of times
the technicians perform preventative maintenance on the medical equipment in the hospital. This sheet records the
details of how the technicians perform preventative maintenance.


Required Participants:
One member of the research team
Translator
Technician


Reference Documents: No reference documents are needed.


Allotted Time: 30 Minutes


Method: This is an interview-assisted survey. One member of the research team will be responsible for asking the
questions via the Preventative Maintenance Sheet and recording the participants’ response.


1. Interview the technician according the left hand side of the Preventative Maintenance Sheet labeled “Script.
2. Record the participant’s responses on the right hand side of the Preventative Maintenance Sheet labeled “Form”


 Anytime this symbol [ ] is present, circle the if the research team has seen the requested document


 Anytime this symbol [ ] is present, circle the if the research team took a picture or scanned the requested
document


3. The researcher will now ask about the preventative maintenance performed on each type of medical equipment in
the hospital. The current sheet does not include balances, magnetic resonance imaging equipment, micropipettes,
and pulse oximeters. If these types of equipment were present in the hospital, the researcher should also probe on
these types of equipment.


4. The research team will need to ask about each piece of medical equipment that is present in the hospital.


Say: “Let’s first discuss the patient monitors.”


5. The research team will then identify if the technician has any paperwork for the preventative maintenance
performed. If the technician has paperwork, the researcher should circle the “M” in the “Memory/Paperwork”
column. If the technician does not have any paperwork for the preventative maintenance, then the researcher
should circle the “P” in the “Memory/Paperwork” column.


6. The research team needs to identify the number of times preventative maintenance was performed on the piece of
equipment in the past times months and the number of times that maintenance was planned.


Say: “How many times in the past 12 months have you performed preventative maintenance on patient monitors?”


Write this reported number on the left hand side of the “/” in the “Times Completed / Times Planned” column.


Say: “How many times did you plan to perform preventative maintenance on patient monitors in the past 12
months?


Write this reported number on the right hand side of the “/” in the “Times Completed / Times Planned” column.


7. The researcher will then need to identify the number of pieces of that type of equipment the technician worked on.


Say: “How many patient monitors did you perform preventative maintenance on each time you completed the
maintenance?”


Write this reported number in the “# worked on” column.




Robert Malkin’s Preventative Maintenance Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



29




8. The researcher will now ask about the technician’s assistance during preventative maintenance.


Say: “While performing preventative maintenance on patient monitors, did you contact anyone for assistance?”


If the technician responds in the negative, circle the N in the “Contact anyone for assistance” column and proceed to
step 9.


If the technician responds in the affirmative, circle the Y in the “Contact anyone for assistance” column. The
researcher then needs to ask who the technician contacted.


Say: “Who did you contact for help?”


Write the reported person next to the “Who” in the “Contact anyone for assistance” column.


9. The researcher will now ask if the technician opened the machine during preventative maintenance.


Say: “Did you open the medical equipment while performing preventative maintenance on patient monitors?”


If the technician responds in the negative, circle the N in the “Open the Machine” column. If the technician responds
in the affirmative, circle the Y in the “Open the Machine” column.


10. The researcher will now ask if the technician cleaned the machine during preventative maintenance.


Say: “Did you clean the medical equipment while performing preventative maintenance on patient monitors”


If the technician responds in the negative, circle the N in the “Clean the machine” column. If the technician responds
in the affirmative, circle the Y in the “Clean the machine” column.


11. The researcher will now ask if the technician calibrated the medical equipment.


Say: “Did you calibrate the medical equipment while you performed preventative maintenance?”


If the technician responds in the negative, circle the N in the “Calibrate” column. If the technician responds in the
affirmative, circle the Y in the “Calibrate” column.


12. The researcher will now ask if the technician used any other parts during the preventative maintenance.


Say: “Did you use any spare parts while you performed preventative maintenance on patient monitors?”


If the technician responds in the negative, circle the N in the “Use any parts” and proceed to Step 13.


If the technician responds in the affirmative, circle the Y in the “Use any parts” and then the researcher needs to
follow-up with the types of spare parts used.


Say: “What spare parts did you use while performing preventative maintenance on patient monitors?”


Write the identified spare parts next to the “Parts” section in the “Use any parts” column.


13. Use the “What did you do?” column to write down any additional information the technician identified.
14. Repeat steps 4- 13 until the researcher has discussed each type of medical equipment.




Robert Malkin’s Management Action Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University





Hospital: Date:
30


In this survey, we will be asking you questions about the management actions you have performed over the past
12 months. This survey will take approximately 30 minutes.


Script # of times Description of Steps
1. How many times have you created an inventory?


Please describe your process to create an
inventory.




2. How many times have you updated the inventory?
Please describe your process to update an
inventory.




3. How many times have you created a Planned
Preventative Maintenance Schedule? Please
describe how you create a Planned Preventative
Maintenance.




4. How many times have you ordered spare parts?
Please describe your process to order spare parts.




5. How many times have you written a report for the
hospital administration? Please describe what
topics are written in your reports.





6. How many times have you written a report for
Ministry of Health? Please describe what topics are
written in your reports.




7. How many times have you developed a budget?
Please describe how you develop a budget.





8. How many times have you written a budget
request? Please describe what you include in your
budget request.




9. How many times have you planned for the
replacement of medical equipment? Please
describe how you plan for the replacement of
medical equipment.




10. How many times have you decided a broken piece
of equipment should stay permanently broken?
Please describe which types of equipment you
decommissioned and how many of each type.





11. How many times have you installed a piece of
equipment? Please describe the installation
process.




12. How many times have you attended meetings with
hospital administrators? Please describe what you
discuss during these meetings.




13. How many times have you attended meetings with
your boss? Please describe what you discuss during
these meetings.




14. How many times have you presented at the
meetings with hospital administration? Please
describe what topics you presented on in these
meetings.





Robert Malkin’s Management Action Survey


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University





Hospital: Date:
31


15. How many times have you called a service
contractor? Please specify which service
contractors you called and for what reasons.




16. How many times have you called a private
company or private technician? Please specify
which private companies or technician you called
and for what reasons.




17. How many times have you developed purchasing
goals? Please describe how you develop purchasing
goals.




18. How many times have you performed electrical
safety testing of medical equipment? Please
describe how you perform an electrical safety test.




19. How many times did you identify training needs of
the users? Please describe the training needs and
the actions you took.




20. How many times did you perform user training? Gather this information from the informal survey sheet




Robert Malkin’s Management Actions Survey Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



32




Purpose: The Management Action Survey allows the research team to gain information about technician’s involvement


in the management of the medical equipment and their interactions with administrators.


Required Participants:


One member of the research team


Translator


Technician


Reference Documents: No reference documents are needed.


Allotted Time: 30 Minutes


Method: This is an interview-assisted survey. One member of the research team will be responsible for asking the


questions via the Management Actions Survey and recording the participants’ response.


1. Interview the technician according the left hand side of the Management Action Survey labeled “Script.


2. Record the participant’s responses on the right hand side of the Management Actions Survey labeled “# of times”


and “Description of Steps”.




Robert Malkin’s Informal Equipment Interaction


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



Hospital: Date:
33


Equipment Type User Training1
Changed Equipment


Settings2
Used Testing
Equipment3


Functional
Testing


What did you do? [additional information]


_1
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:




_2
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_3
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_4
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_5
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_6
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_7
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_8
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_9
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:


_0
Y N
Frequency: Number of People:


Y N
Frequency:


Y N
Frequency:


Y N
Frequency:



1 Use the number of user of trainings gathered here to fill out the “User Training” section on the Management Actions Instrument
2 Add the number of times the technician changed the equipment setting gathered here to repairs performed in order to calculate the final corrective actions performed
3 Add the number of times the technician used testing equipment into the total number of preventative actions




Robert Malkin’s Informal Equipment Interaction


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



Hospital: Date:
34





Robert Malkin’s Informal Equipment Interaction Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



34


Purpose: The Information Equipment Interaction Sheet allows the research team to gain information about times when


the technician checked on the medical equipment but did not perform planned preventative maintenance and it allows


the researchers to gain more extensive information that will get re-categorized as either a management or corrective


action.


Required Participants:


One member of the research team


Translator


Technician


Reference Documents:


Medical Equipment List


Allotted Time: 30 Minutes


Method: This is an interview-assisted survey. One member of the research team will be responsible for asking the


questions via the Informal Equipment Interaction Sheet and recording the participants’ response.


1. Preface this survey by saying:


“In this next survey, we will be asking you questions about the number of times you have provided user training,


calibrated medical equipment, changed equipment settings, and used testing equipment for each type of


medical equipment present in your hospital. We are only interested in the actions you have performed in the


past 12 months. This sheet will take approximately 30 minutes. Do you have any questions before we start this


survey?”


2. Use the Medical Equipment List reference sheet to systematically go through the equipment in the hospital. The


research team will need to ask about each piece of medical equipment that is present in the hospital.


Say: “Let’s first discuss anesthesia machines [or the first type of medical equipment on the medical equipment


list present in the hospital]."


Write ANMA in the left hand column under Equipment Type.


3. The researcher will now ask about the number of times the technician performed user training on the specific piece


of equipment in the past 12 months. User training is defined as the technician teaching at least one user (such as a


doctor or nurse) about at least one specific action for a piece of medical equipment. For example, the technician


may teach a nurse about to properly clean out a suction machine after the nurses uses it or the technician may


teach the entire department staff about how properly unplug/plug a piece of equipment in order to take care of the


cord’s longevity or be aware of safety issues.


Say: “In the past 12 months, have you performed any training to the hospital staff on the anesthesia machines”


If the technician responds in the negative, circle the N in the User Training box and proceed to step 4.


If the technician responds in the affirmative, circle the Y in the User Training box. The researcher needs to ask about


the number of times the technician performed this user training and the number of people who attended each


training.




Robert Malkin’s Informal Equipment Interaction Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



35


Say: “How many times in the past 12 months, did you perform trainings on the anesthesia machines”


Write this number under “Frequency” in the User Training box on the line corresponding with medical


equipment being discussed.


Say: “In each of these training, how many people were present?”


Write the number of people present under “Number of People” in the User Training box.


4. The researcher will now ask about the number of times the technician changed equipment setting on the specific


piece of equipment in the past 12 months. Changed equipment setting is defined as the technician being called to a


department due to a non-functional piece of equipment and the only action the technician needed to take was


change the settings in order for the piece of equipment to become functional.


Say: “In the past 12 months, have you ever been called to the department because the anesthesia machine was


broken and upon your evaluation of the equipment, the only action you needed to perform was to change the


equipment settings?”


If the technician responds in the negative, circle the N in the Changed Equipment Settings box and proceed to


Step 5.


If the technician responds in the affirmative, circle the Y in the Changed Equipment Settings box. The researcher


needs to ask about the number of times the technician changed the equipment settings.


Say: “How many times have you had to change the anesthesia machine’s settings in the past 12 months?”


Write this number under the “Frequency” in the Changed Equipment Settings box


5. The researcher will now ask about the number of times the technician used testing equipment on this piece of


equipment. If the technician did not specify having the appropriate testing equipment for the piece of equipment in


the Technician Survey, then the researcher can skip this question and proceed to Step 6.


Say: “In the past 12 months, have you ever used testing equipment on the anesthesia machine?”


If the technician responds in the negative, circle the N in the Used Testing Equipment box and proceed to Step 6.


If the technician responds in the affirmative, circle the Y in the Used Testing Equipment box.


Say: “How many times did you use this testing equipment on the anesthesia machine in the past 12 months?


Write this number under the “Frequency” in the Used Testing Equipment box and the type of testing equipment


used in the “What did you do?” box.


6. The researcher will now ask about the number of times the technician performed a functional test on this piece of


equipment. A functional test is defined as the technician turning the piece of equipment on and then performing no


other action.


Say: “In the past 12 months, have you ever turned on the anesthesia machine to make sure it is working,


performed no action, and then turned it off upon seeing if it was working or not?”


If the technician responds in the negative, circle the N in the Functional Testing box and proceed to Step 7.




Robert Malkin’s Informal Equipment Interaction Script


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



36


If the technician responds in the affirmative, circle the Y in the Functional Testing box. The researcher needs to


ask about the number of times the technician performed a functional test in the past 12 months.


Say: “How many times in the past 12 months, did you perform that action?”


Write the number under the “Frequency” in the Functional Testing box.


7. Record any additional information the technician explains in the “What did you do?” box.


8. Repeat Steps 2-7 until every type of medical equipment has been discussed. Use the “Medical Equipment List”


reference to systematically go through the equipment.


9. Calculate the total number of user training. First, multiply the number of people by its corresponding frequency


number. Second, add together all of these sub-totals to calculate the total number of user training. Write the total


number of user trainings in the “User Training” section on the Management Actions Instrument.


10. Calculate the total number of changed equipment settings by summing all the frequency numbers. This number


should get added into the total number of corrective actions.


11. Calculate the total number of using testing equipment by summing all the frequency numbers. This number should


get added into the total number of preventative actions.




Robert Malkin’s English Test


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University




37




Reference: English Test


This is the Reference Sheet for the Language Section of the Technician Survey. Please have the
technician read and respond to each of the below statements.


1. What are your normal work hours?


2. What is your job title?


3. Show me your tool box.




Robert Malkin’s Tool List


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University





38


Reference: Tool List


This is the Reference Sheet for the Shop Section of the Technician Survey. Prior to the survey each tool needs to be transated
into the local language. The translated word should be placed in the yellow space below each picture.




1 [ ]


1 Calipers






2 [ ]


2 Flashlight




3 [ ]


3 Calculator




4 [ ]


4 Brush for Cleaning (any)






5 [ ]


5 Tool Case




6 [ ]


6 Glasses / Safety Goggles






7 [ ]


7 Magnifying Lens




8 [ ]


8 Measuring Tape




9 [ ]


9 Cable Ties




10 [ ]


10 Allen Wrench Set






11 [ ]


11 Pipe wrench




12 [ ]


12 Adjustable crescent wrench




13 [ ]


13 Box wrench set




Robert Malkin’s Tool List


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University





39






14 [ ]


14 Level






15 [ ]


15 File






16 [ ]


16 Electrical Tape






17 [ ]


17 Rubber or plastic mallet




18 [ ]


18 Hammer






19 [ ]


19 Socket Set






20 [ ]


20 Pliers, Lineman's




21 [ ]


21 Pliers, Needle-nose




22 [ ]


22 Pliers, Slip Joint




23 [ ]


23 Pliers, Vise Grip (mole)






24 [ ]


24 Pocket Knife








25 [ ]


25 Razorblade Scraper





Robert Malkin’s Tool List


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University





40






26 [ ]


26 Utility Knife, With Blades




27 [ ]


27 Wire cutters






28 [ ]


28 Wire Stripper




29 [ ]


29 Alligator Clip Leads






30 [ ]


30 Philips Screwdriver




31 [ ]


31 Flat Tip Screwdriver




32 [ ]


32 Miniature/Jeweler’s Screwdriver Set




33 [ ]


33 Soldering Iron






34 [ ]


34 Metal Saw




35 [ ]


35 Wood Saw






36 [ ]


36 Pressure meter




37 [ ]


37 Multimeter




Robert Malkin’s Tool List


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University





41




38 [ ]


38 Oscilloscope






39 [ ]


39 Electrical Safety Analyzer




40 [ ]


40 Cardiac Simulator




41 [ ]


41 Electrosurgical Analyzer




42 [ ]


42Defibrillator Analyzer






43 [ ]


43Tap and Die Set





Robert Malkin’s Supply List


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University





42


Reference: Supply List

This is the Reference Sheet for the Supply Section of the Technician Survey. Prior to the survey,
each supply needs to be translated into the local language. The translated word should be placed in
the yellow space next to each number.

Electrical


1. Wire nuts [ ]
2. Solder flux [ ]
3. A spool of spare wire [ ]
4. Heat shrink tubing [ ]
5. Sandpaper [ ]
6. Spare resistors [ ]
7. Desoldering braid, bulb, sucker [ ]
8. Spare lightbulbs [ ]
9. Velcro strips [ ]
10. Caulk [ ]


Mechanical
11. Cleaning solvents like alcohol, acetone, or ammonia [ ]
12. Steel wool [ ]
13. Thin penetrating oil [ ]
14. Grease / machine oil [ ]
15. Spare screws [ ]
16. Super glue or cyanoacrylate [ ]
17. Compressed air, can or machine [ ]
18. Epoxy [ ]


Plumbing
19. Rubber patch kit [ ]
20. Access to rubber gasket replacement material [ ]
21. Replacement O rings [ ]
22. Gloves [ ]


Power
23. Spare fuses [ ]
24. Access to spare batteries [ ]




Robert Malkin’s Medical Equipment List


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University




43


Reference: Medical Equipment List



Code Equipment Type
ANMA Anesthesia Machines


AUCL Autoclaves


BALA Balances (electronic clinical lab)


BPMA Blood Pressure Machines (manual & NIBP)


CENTR Centrifuges (including hematocrits)


CLOV Clinical Laboratory Ovens


DFIB Defibrillators


ECGR Electrocardiographs


ESUM Electrosurgery Machines


FEMD Fetal Monitors and Fetal Dopplers


FLPU Fluid Pumps (feeding, IV infusion/syringe, blood etc.)


HEAN Hematology Analyzers (including electrolyte analyzers)


ININ Infant Incubators


INFW Infant Warmers


LAIN Laboratory Incubators


MARI Magnetic Resonance Imaging


MIPI Micropipettes (manual, electronic, not disposable)


MICS Microscopes


MICT Microtomes & Cryostats


NEBU Nebulizer


OPTA Operating Tables


ORLI OR Lights and Other Lights


OXCO Oxygen Concentrators


PAMO Patient Monitors


PHLI Phototherapy Lights


PUOX Pulse Oximeters


REFR Refrigerators


RERM Respiration Rate Meters and Apnea Monitors


SUMA Suction Machines (rotary, diaphragm, thermotic, venture)


ULTR Ultrasounds


VENT Ventilators


WABA Water Baths, Stir Plates, and Hot Plates


WAPU Water Purifiers (for clinical lab)


XRAF X-ray (fixed – radiographic and/or fluoroscopic unit)


XRAP X-ray (portable – such as C-arms)


XRFP X-ray Automatic Film Processor





Robert Malkin’s Biomedical Technician’s Assistant Skills


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



44




Reference: Biomedical technician’s assistant (BTA) Skills



Electrical Simple
 Connections


3 – Broken Wires inside cable
10 – continuity tester
8 – Desoldering
5 – heat shrink tubing (diameter)
4 - Proper use of electrical tape
9 - Selecting wire (diameter, type


(solid/stranded), insulation,
material (aluminum, copper))


7 - Soldering (stranded wires,
solid wires, to PCB board)


6 - Wire nuts
 Connectors


12 - Broken housing
13 - Cleaning of connections (Q-


tips, isopropyl alcohol)
14 - Conductive epoxy
16 - Loose Connectors
17 - Strain Relief
18 - Wire/ rod to replace pins of a
connector


 Fabrication (cables, electrodes, plates)
19 - Cables (simple cables,


shielded cables)
20 - ECG Cables
21 - ECG Electrodes
22 - Patient Reference Plates for
ESUs
23 - Temperature Probe Cables


 Heating Element
25 - Replacement of Heating


Element
26 - Replacement of temperature


sensing device
 Lighting/ Indicators


28 - cleaning bulb connections
29 - cleaning high temperature/


high intensity bulbs
30 - Fixtures (electrical rewiring,


mechanical adaptations)
31 - Replacement of Light bulbs


(incandescent, fluorescent, LED)


32 - Replacing Analog Meters
 Switches


34 - Cleaning Contacts
35 - Selecting Replacement


Switches


Mechanical
 Attachment


37 - drilling holes (in metal,
ceramic & wood)


38 - epoxy
39 - loosening frozen nuts
40 - nails/ hammer
41 - plastic anchors
42 - Selecting replacement screws
43 - soldering (brass tubing)
44 - superglue
45 - tightening nuts
46 - tools for adjusting bolt/screw


choosing different heads
47 - understanding welding
48 - zip ties


 Calibration
50 - BP machines
55 - Centrifuge
? - Defibrillator
51 - ECG monitor
52 - Oxygen concentrator
53 - Scale
54 - Sphygmomanometer
? - Training
56 - Ventilator volume/ rate


 Casing
58 - hinges
59 - latches/locks/interlocks
60 - Panels/ doors (from wood,
sheet metal)


 Cleaning
62 - Cleaning inside of things (pipe


cleaners, Q-tips, tweezers with
a bit of cloth)


63 - cleaning lens/using lens paper
64 - compressed air
65 - rust/ sanding




Robert Malkin’s Biomedical Technician’s Assistant Skills


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



45




66 - Using a damp cotton cloth
(water, soap and water,
clorox, acetone, alcohol)


 Lubrication
68 - greasing/ oiling
69 - thin penetrating oils
70 - unfreezing painted joints


Motors
 Belts/ Gears/ Shafts/ Coupling


72 - Bent Shaft (vibration and wobbling)
73 - Loose/ tighten
74 - Lovejoy Coupling (vibration/


slipping)
75 - Squealing/slipping/ low power
76 - worn cracks/ glazing


(replacing belt)
 Brush Substitution


78 - Filing down
79 - Shim
80 - Spring adjustment (attached


to brush)
81 - Spring repair


 Cleaning/ Lubrication
83 - Arcing grooves in commutator


(removal with emery paper)
84 - Arcing grooves in commutator


(Removal with lathe)
85 - Brush frozen away from


commutator (cleaning)
86 - Grinding/ high pitched squeal


(foreign objects)
87 - Lubricant (type, reservoir)
88 - Repack bearings
89 - Squealing/ Grinding/


Overheating
 LoveJoy coupling


91 - Sheared key
 Tightening/ Attachment/ Balance


93 - Mounting of motor
94 - Set Screws(Loc-tite/superglue)
95 - Vibration and motor



Plumbing
 Blockages


97 - Cleaning
98 - Descaling


99 - Routing
 Connections


101 - Clamps
102 - Fitting adaptors
103 - Hose Barb w/ clamp
104 - Threaded pipe connector


 Filters
106 - Cleaning
107 - Fabrication
108 - Substitution


 Leaking
110 - Cutting Tubes
111 - epoxy
112 - Finding Holes
113 - Melting Tube
114 - Rubber Patches
115 - superglue
116 - Tape


 Seal
118 - Caulk
119 - Creating a gasket
120 - Jars/lids for Suction machines


 Rings
121 - O-rings
122 - Sealing autoclave doors



Power Supply
 Batteries


124 - Building/ adapting a charger
for rechargeable cells


125 - Cleaning
126 - Identification of


leaking/corrosive batteries
127 - Replacing batteries with a


wall transformer
128 - substituting for batteries for


primary cells
129 - substituting for batteries for


rechargeable cells
 Fuse


131 - fuse substitution
132 - identifying a blown fuse


 Plug/cable
134 - Adding proper grounding
135 - Fabricating power cords
136 - Outlets and plugs for different




Robert Malkin’s Biomedical Technician’s Assistant Skills


Developing World Healthcare Technology Laboratory BMET Assessment


at Duke University



46




voltages/countries (determine
frequency voltage, determine
configuration)


 Regulator
138 - Diagnose regulator problems
139 - Replacing/adapting regulators


 Transformer
141 - Adapting wall transformers
142 - Diagnosing a transformer that


needs to be rewound (appropriate
people to rewind transformers)


143 - Voltage conversion transformers




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