A PROPOSAL
New MSQH (Malaysian Society for Quality in Health) policy for Electrical System at Critical Area.
1. Critical Area
Critical Area in the hospital covers two (2) sections, which are;
OT Room and Recovery area
ICU/CICU/NICU
2. Existing HTS Policy
These area must be supplied by electrical power 100% of total uptime and also backup with the UPS (Uninterruptible Power Supply) System which includes lighting, and power point system.
3. New Policy
All critical area as mentioned above should have three (3) source of electrical power as below:
Normal supply – Normal electrical supply from TNB distribution
Generator System – Electrical supply from generator set if there is TNB power loss
UPS System – Electrical supply provided particularly to life-support systems as backup incase the generator breakdown or power irregularity.
The objective of the above is to ensure at any time, there will be at least 1 source of power supply at the critical areas.
HTS PROPOSAL
1. Special requirement
The following item cannot be connected to UPS system;
OT light
Anesthetic machines
All active power points for equipment/tools in OT rooms or ICU equipment
2. Distribution of power
The electrical power distribution is divided to:
i)
UPS – 50%
ii)
Generator – 30%
iii)
TNB supply – 20%
Total
100%
3. Scenario
Typical ICU:
Unit of Power Point:
· 10 power point is required for active equipments supplied by the UPS
· For backup system,
- 6 power points (genset supply)
- 4 power points (TNB supply)
Unit of light:
If ICU typical room required four (4) unit lights, the power distribution for each system as below:
· 2 lights – UPS system
· 1 light – generator system
· 1 light – TNB supply
Predictive Maintenance: DiagnosisIt used to be a relatively common practice for plants to wait for equipment to fail, and then repair it. A range of predictive technologies can be implemented to detect developing machinery faults at an early stage, before they become problematic. These predictive technologies can include performance parameter sensors, specialized monitoring devices, and analytical and data management software to capture, trend, diagnose and report timely information on the operating conditions of machinery assets.
The key to choosing appropriate predictive technologies is to understand
how a particular machine fails?,
what symptoms would be visible and detectable before it fails?, and how fast that machine would deteriorate?.Measuring Effects of Vibration
Many machinery problems manifest as vibration, which is widely considered the best operating parameter to assess a machine’s condition. Vibration can detect machine fault conditions, such as:
• Unbalance.
• Misalignment.
• Oil film bearing instabilities.
• Rolling bearing degradation.
• Mechanical looseness.
• Structural resonance.
• Soft foot.
• Rotor bow.
• Cracked rotors.
Vibration measurements are also quick and fairly non-intrusive since the operating equipment is undisturbed. Collected vibration measurements can be analyzed on the spot or downloaded to a specialized software application on a computer work station or network for analyzing, long-term trending and reporting abnormalities.
Detecting Defects in BearingsThe vibration measured at a machine’s bearings can open a window into equipment health because most machine problems have distinct vibration symptoms. A bearing can degrade due to:
• Improper lubrication.
• Contaminated lubrication.
• Heavier loading than anticipated, often caused by other machinery problems such as imbalance, misalignment or a bent shaft.
• Improper handling or installation.
• Surface fatigue.
• Misapplication.
If these symptoms are detected and properly analyzed, and the progression of the damage is monitored accordingly, these signals provide maintenance personnel adequate time to correct the cause of the bearing problem.
Analyzing Condition of LubricantLubricant inspection and analysis serve as a particularly practical method to help detect problems with machinery assets, especially since many characteristics can be examined visually.
• Water contamination can be observed with clarity in a standing sample.
• Ferrous materials (filings, metal dust, etc.) can be detected using a magnet drawn up the side of a glass jar containing lubricant diluted with a solvent.
• Flow and discoloration can be noted in a bull’s-eye sight glass.
• Non-ferrous particles can be evaluated by residue on filter paper.
• Viscosity can be monitored using simple in-plant tools.
Before embarking on any predictive maintenance program, a clearly defined maintenance strategy should be in place. Decisions to apply related technologies should be prioritized according to the risks associated with equipment failure, the possible financial consequences, the impact on the safety of personnel, production processes and the environment.
The Electronic Diagnose Pen
By Dave Staples, Copyright of Chem, Advantage Business Media, June 2008.
“Towards Hospital Intelligence Practices“
Private Healthcare Facilities and Service Regulation 2006
By referring Part XVI – Special Requirement for Critical Care Unit or Intensive Care Unit, Clause 221 (a-e) - Facilities and design features, stated that:-
a) adequate supply and distribution of oxygen and medical gas, suction, electricity, lighting and air conditioning with provision for emergency back-up in the event of failure or breakdown of supply;
b) Capability to separate or isolate infected patients or patients at particular risk of infection;
c) Readily accessible hand washing facilities to staff in the critical care unit or intensive care unit and in each patient room;
d) Adequate facilities for appropriate diagnostic , monitoring, therapeutic intervention and life support facilities; and
e) Adequate equipment and monitors for the transport of patients.
Remark:
According to above statements, the law does not state any temperature requirement in an ICU. Through the committees’ discussion, HTS proposed that the ICU temperature shall be 20 to 22 degree Celsius.
The twelve air change term has been proposed recently by the HTS technical committees’ as six out of twelve air change shall be contained fresh air and recycle air for the excess proportion in ICU.
Notes: Please do refer to Table 3 : General Pressure Relationship and Ventilation of Certain Hospital Areas for further information.
According to ASHRAE Handbook 2005, Air Change Effectiveness is a description of an air distribution system’s ability to deliver ventilation air to a building, zone, or space.
One common definition of air change effectiveness is the ratio of a time constant to an age of air.
The age of air is the length of time that some quantity of outside air has been in a building, zone, or space. The “youngest” air is the point where outside air enters the building by forced or natural ventilation or through infiltration.
We are looking forward to any comments or suggestion beyond this topic to enhance our expertise and improve the hospital technical comprehension. Your contributions are most welcome.
“Towards Hospital Intelligence Practices“
By Referring to Part XVI – Special Requirement for Critical Care Unit or Intensive Care Unit, Clause 223 (a) and (e) stated that:-(a)
“A minimum of two oxygen outlets, one suction outlet and one compressed air outlet adjacent to each bed”
(e)
“An emergency call system at each bed and nurses station”
Standard bed head CCU/ICU unit component:-
Item 1-P switch sockets outlets
Item 2-5-gas points
Item 3 -1-emergency button
Item 4 -1 only 300mm gabler rail
Top half consists of:
Item 1-58w uplight switched at door.
Item 2-gas brackets & piping run in separate compartment covered with PVC cover.
Item 3-nurse call in separate compartment covered with PVC cover.
Item 4-fascias punched to suit equipment.
Item 5-500mm gabler rail.
Item 6-R45 telephone jack
Bottom half consists of:Item 1-18w reading light switched on unit or relayed switched via nurse call
Item 2-5w PL nightlight switched on unit.
Item 3-2 only 16A switch socket outlets crabtree.
Item 4-equipment plug 2pin & switch.
Item 5-fascias punched to suit equipment.
Notes: A bed head panel is designed to cater maximum medical requirement to support patient needs... This is why the outside component always lesser than the inside...
What do you think?Please leave your commentary in the comment section...thank you:)“Towards Hospital Intelligence Practices“
Private Healthcare Facilities and Service Regulation 2006By referring Part X - General Provisions for Standards of Private Healthcare Facilities or Service, Chapter 7-Ventilation, Clause 10 (c) stated that:-
The ventilation for newborn nursery shall have a minimum ventilation rate of twelve air change per hour which is provided by mechanical supply and exhaust air systems.
Remark:
The “twelve air change” term mentioned above bring out an ambiguous meaning to the hospital planners. Through the committees’ discussion, HTS proposed that five out of twelve air change shall be contained fresh air and recycle air for the excess proportion.
Notes:
Please do refer to Table 3 : General Pressure Relationship and Ventilation of Certain Hospital Areas for further information.
We are looking forward to any comments or suggestion beyond this topic to enhance our expertise and improve the hospital technical comprehension. Your contributions are most welcome.
“Towards Hospital Intelligence Practices“
Please leave your commentary..... thank you :-)
