Medical City · Simulation 07 of 12
Preventive Maintenance
Plan the week by risk, then run each PPM on the bench against its limits.
What you do
Preventive maintenance week
Planned preventive maintenance (PPM) proves, on a schedule, that each device is still safe and still does what its specification says. This challenge takes you through a week: plan the work by risk, then take each device on your bench through inspection, electrical safety, function and a signed report.
Clinicians trust a device because it carries a PASSED tag. If the PPM was rushed, done in the wrong order or judged against the wrong limits, that trust is misplaced, and the fault is found by a patient instead of by you.
42 challenges, each at Foundation, Practitioner and Expert level.
How it works
Step by step.
Plan the week by risk
Placing this week's work orders on Monday to Friday within the technicians' hours and the test equipment available each day. Plan by risk and overdue days, around the scarcest test equipment, and write down what you defer.
Choose the work in hand
Reading the work orders on your bench: each card shows the device, its location, how overdue it is and its history since the last PPM. History points you at a test; a clean history never lets you skip one.
Visual inspection first
Inspecting the device before any power: enclosure, labels and mains cable, then the device's own accessories and mechanisms. Look before you power up; cosmetic wear is not a defect, a breached barrier is.
Electrical safety, IEC 62353
Testing electrical safety to IEC 62353: protective earth (Class I only), insulation, equipment leakage and applied part leakage, against limits set by the device's class and type. Read the class and applied part type first; the limits follow from them.
Function and performance
Verifying the device against its specification with the right test equipment: outputs, accuracy, alarms and battery. Inside the limit passes, however close; outside fails, however close.
Service report and tag
Signing off the device: one of four outcomes, the primary finding, the action taken and the next PPM date. Fix what you can, fail what you must, escalate what is not yours to repair.
What it trains
Skills and competencies.
- Risk-based PPM planning (equipment management number)
- IEC 62353 recurrent electrical safety testing
- Performance verification against specification
- Pass, minor action, fail or escalate decisions
In the BMEssentia competency framework, this simulation builds 5 competencies across Patient & Electrical Safety, Maintenance & Performance Testing.
- Patient & Electrical Safety
Electrical safety testing
Test medical electrical equipment to IEC 62353 (earth bond, insulation, leakage) and act correctly on borderline and failed results.
- Maintenance & Performance Testing
Risk-based maintenance planning
Set planned preventive maintenance intervals and priorities by device risk, failure history and manufacturer advice.
- Maintenance & Performance Testing
Performance verification and calibration
Prove a device does what its specification says using analysers and simulators, and judge results against tolerance.
- Maintenance & Performance Testing
Test methods and measurement uncertainty
Choose test conditions that can reveal the fault, use traceable test equipment and judge results within measurement uncertainty.
- Maintenance & Performance Testing
Service records and documentation
Keep complete, honest and timely CMMS records, job sheets and device tags so every action can be traced and trusted.
The takeaways
- Plan by risk, not by convenience.
- Electrical safety before function, earth before leakage.
- Change the limits with each device's class and applied part type.
- The tag must match what the results support.
The challenges
42 training cases.
- 01 Ward 4 pump fleet PPMFoundation
Ward 4's volumetric pumps are due their annual PPM, and the ward has had two 'pump not delivering' calls this month that turned out to be nothing.
- 02 Children's ward syringe driversFoundation
Our four syringe drivers are due their annual PPM and I would like them back by tomorrow's drug round.
- 03 Nutrition team enteral pumpsFoundation
The nutrition team's enteral pumps are overdue, and we have had one feed run by gravity on Ward 9 when a carer took the set out.
- 04 Ward 11 oximeter fleet PPMFoundation
Ward 11 scores its early warnings on four bedside pulse oximeters, and all four are due their annual PPM.
- 05 Transfer service ventilatorsFoundation
The four transport ventilators that go with our ambulance transfers are due their annual PPM, and the service has two loan ventilators until tonight.
- 06 Postnatal phototherapy unitsFoundation
We treat jaundiced babies at the mother's bedside with our four LED phototherapy units, so mothers and babies are not separated.
- 07 Birth centre outreach visitFoundation
Riverside is our freestanding midwife-led birth centre, forty minutes away by road.
- 08 Defibrillator readiness auditIntermediate
The Resuscitation Committee wants assurance that every defibrillator in the hospital will work at the next arrest.
- 09 ICU monitors before the CQC visitIntermediate
The CQC inspectors arrive on Thursday morning and they will ask for the PPM record of every device in the unit.
- 10 ED resus: suction and blood pressureIntermediate
Resus has two portable suction units and two automated BP monitors due their PPM, and I can only spare them for the morning.
- 11 Cardiology ECG cartsIntermediate
Four ECG carts from the cardiology clinic are on your bench.
- 12 PCA audit after an overdoseIntermediate
On Saturday night a patient on Ward 12 was found over-sedated on morphine PCA and needed naloxone.
- 13 Community syringe driversIntermediate
Four syringe drivers have come back from patients' homes after bereavements, and we need them out again within days: there is a waiting list for end-of-life care at home.
- 14 Equipment library turnaroundIntermediate
Monday is turnaround day.
- 15 Oximeters after a complaintIntermediate
A patient with COPD on Ward 6 had an arterial gas showing a saturation of 84% while the bedside oximeter read 92%.
- 16 Day surgery: anaesthetic kitIntermediate
The Day Surgery Unit closes on Monday for staff training: the only day this month that both anaesthetic rooms are empty.
- 17 ICU transfer kit auditIntermediate
Last month a transfer to the regional neurosurgical centre was delayed forty minutes because the ventilator's cylinder emptied faster than the team had calculated.
- 18 Delivery suite resuscitairesIntermediate
Every baby born on the delivery suite is dried and assessed on a resuscitaire, and the sick ones stay on it through the first hour.
- 19 Labour ward CTGs after a reviewIntermediate
A case review found that decelerations on a CTG last month were recognised late.
- 20 Maternity unit inspectionIntermediate
The CQC are inspecting maternity services in two weeks, and equipment checks were a finding at the last inspection.
- 21 Theatre ESUsAdvanced
Four electrosurgical units are booked out of Theatres for their six-monthly PPM and the lists start again at 13:00.
- 22 Neonatal incubatorsAdvanced
Four incubators are clean and ready for their six-monthly PPM.
- 23 Dialysis unit: water and electricalAdvanced
Four haemodialysis machines are due their PPM before the Tuesday sessions.
- 24 ICU ventilators: six-monthly PPMAdvanced
Four ventilators are out for their six-monthly PPM, with the manufacturer's service kits on the bench.
- 25 Neonatal syringe pumps, low ratesAdvanced
Our babies have inotropes, insulin and morphine running at fractions of a millilitre an hour, often through umbilical lines.
- 26 Theatre recovery before the listAdvanced
We have a full orthopaedic list today that cannot be cancelled: eight joint replacements, all going home to the wards on PCA.
- 27 Field safety notice: driversAdvanced
The manufacturer has issued a field safety notice for series S5 syringe drivers with serial numbers S5-334000 to S5-334999: the occlusion force sensor can drift.
- 28 The list that cannot be cancelledAdvanced
It is 21:00.
- 29 Theatres before the inspectionAdvanced
The CQC will inspect surgical services on Thursday, and they will start in theatres: the anaesthetic machine checks, the PPM records and anything overdue.
- 30 After the vaporiser incidentAdvanced
8%.
- 31 Neonatal unit mixed roundAdvanced
Five devices from one nursery, all due together: an incubator, a phototherapy unit, a resuscitaire, an infusion pump and a bedside monitor.
- 32 Special care backlog weekAdvanced
The special care baby unit's equipment fell behind while its link technician was on long-term sick leave: most of it is overdue, some by months.
- 33 Birthing pool and CTG telemetryAdvanced
Our alongside midwifery unit has two birthing pool rooms.
- 34 Backlog crisis: 140 overdue PMs, 3 techniciansExpert
After the summer vacancies we have 140 PPMs overdue across the hospital and three technicians, each with about four and a half hours a day of planned time once.
- 35 Post-incident PPM reviewExpert
Last Tuesday a volumetric pump on Ward 7 free-flowed about 60 mL of heparin when the door was opened.
- 36 Medical ward: mixed PPM roundExpert
This is the round we use to sign technicians off as independent: six different devices from Ward 9, each with its own protocol.
- 37 Winter week: every pump in sightExpert
The winter surge has arrived early.
- 38 Oncology day unit roundExpert
The day unit runs chemotherapy, supportive infusions, PCA for mucositis and enteral feeds for our head and neck patients, all in one room with very sick.
- 39 One gas analyser, two sitesExpert
The trust has one anaesthetic gas analyser between this hospital and the Riverside site, and Riverside has it from Wednesday.
- 40 Community hospital visitExpert
Kirkby Moor is ninety minutes away by road and sees a technician twice a year.
- 41 Winter week, one analyserExpert
Winter has come early: the neonatal unit is over its cot capacity, the delivery suite is running two extra resuscitaires borrowed from paediatrics.
- 42 Cold baby under a warmerExpert
5 °C throughout.