News & Scope Handai Hospital No. 75
Alleviating Pain and Distress of Patients and Families – Palliative Care Center Opens –
|Director (Prof., University Instructor)||Masaki Takashina (Doctor)|
|Deputy Director (Chief Engineer)||Shigeru Minami (Clinical Engineer)|
|Others||Clinical Engineers: 38|
The Department of Clinical Engineering was established in January 1998 as a medical equipment management department, the first among the national university hospitals. It is mainly responsible for maintaining and managing medical equipment in the hospital, particularly that with high frequency of use and related to life support. Information on medical equipment that the center manages is all controlled in a database, so that the entire history of lending and use, inspections during use, maintenance and repairs can be confirmed from purchase until disposal. They also perform ward rounds of medical equipment in use and are on-call, as well as conducting educational activities for doctors and nurses so that the equipment is used correctly and safely for the patients. The Department of Clinical Engineering has 39 qualified clinical engineers* who provide support based on maintenance and management for the Surgical Center, Intensive Care Unit, Clinic of Radiology, Blood Purification Center, Medical Center for Translational and Clinical Research, Trauma and Acute Critical Care Center, and general wards. The clinical engineers of the center are at the forefront of medical care together with doctors and nurses, including heart surgery using a heart-lung machine in the Surgical Center, blood purification and artificial ventilation in the Intensive Care Unit and Blood Purification Center, interventional treatment by cardiac catheterization in the Clinic of Radiology, and heart failure treatment by ventricular assist device as a bridge to heart transplant.
* The medical occupation of clinical engineer (CE) is a medical technologists other than a doctor who, like nurses, radiology technologists, clinical laboratory technicians and physical therapists, provides medical aid. Clinical engineer is a relatively new occupation of about 30 years, having been instituted in 1987, which is nationally certified by the Ministry of Health, Labour and Welfare. Having been licensed by the Minister of Health, Labour and Welfare, a clinical engineer engages in the operation and maintenance of life-support equipment such as heart-lung machines, blood purification equipment and artificial ventilators Intensive care, and is a professional engineer who has medical and technical knowledge of the remarkable advances in medical technology in recent years.
Under the Director and Deputy Director and the clinical engineers are assigned to the ME Center Division or Surgery Division and oversee the work in each department. Some work is addressed in each department and some through inter-departmental cooperation. An education system has been established to handle inter-departmental transfer of staff.
The Surgery Division maintains medical equipment and manages facilities used by the Surgical Center and Intensive Care Unit. Much important medical equipment such as endoscopic devices and electric scalpels for diagnosis and treatment during surgery, navigation devices, minimally invasive therapy devices like da Vinci, percutaneous cardiopulmonary support (PCPS) device, intra-aortic balloon pump (IABP), ventricular assist device (VAD) and blood purification equipment are maintained to be safely used in surgery at any time. Power sources, air conditioning, and water supply/drainage are also very important in performing surgery, and they are responsible for their operational status and initial response to trouble.
The ME Center Division provides a central management system for the loan, return, maintenance and repair of equipment in the outpatient and medical wards, CVCU, CCU, NICU, Blood Purification Center, Intensive Care Unit, Trauma and Acute Critical Care Center, Clinic of Radiology, etc. The working efficiency of the central management system is being improved by partial outsourcing. They also inspect ventilators operated at CVCU, CCU, NICU, Trauma and Acute Critical Care Center and general ward during use, and perform ward rounds of defibrillators (including AEDs) and ventricular assist devices in the outpatient and medical wards. In addition, they maintain blood purification equipment used by the Blood Purification Center and Trauma and Acute Critical Care Center, closed type incubator used by NICU, percutaneous cardiopulmonary support (PCPS) device, intra-aortic balloon pump (IABP) and equipment for cardiac catheters used by the Trauma and Acute Critical Care Center and Clinic of Radiology.
Transcatheter aortic valve implantation（TAVI）has attracted much attention for a high-risk patients with severe aortic stenosis, in recent years. TAVI is far less invasive than conventional aortic valve replacement （AVR） through open-heart surgery.
TAVI was repaid insurance, and Edwards SAPIEN XT became available for clinical use in October 2013. Number of cases about TAVI increases drastically in our hospital. The types of devices have also increased.
In this surgery, scrub Clinical Engineers mount artificial valve with stent on balloon (crimping / loading), and provide technical support about TAVI devices.
Also circulating Clinical Engineers treat medical supplies and related products, and manage devices such as percutaneous cardiopulmonary support （PCPS） device to be available in surgery at any time.
Clinical Engineers provide technical support about endovascular aneurysm repair （TEVAR/EVAR） devices in a hybrid operating room, in close cooperation with other medical staff, especially from inserting introducer sheath into patient to mounting the TEVAR/EVAR devices.
Our hospital has performed prostatectomy using da Vinci surgical system from November 2012. Clinical Engineers supported initial system introduction positively.
Clinical Engineers establish and operate the system safely, and quickly respond to trouble with the system during surgery in routine.
The Surgery Division provides clinical technical support for treatment using blood purification equipment, ventilators, ventricular assist devices, etc. in the Intensive Care Unit. The ME Center Division provides clinical technical support for treatment using blood purification equipment, ventilators, ventricular assist devices, etc. in the Trauma and Acute Critical Care Center.
The Surgery Division provides clinical technical support for treatment using CHDF, plasma exchange, etc. in the Intensive Care Unit. The ME Center Division provides clinical technical support for treatment using hemodialysis, plasma exchange, adsorption, LCAP/GCAP, CHDF, etc. in the Blood Purification Center, Trauma and Acute Critical Care Center, Heart Center and others. In addition, we are conducting the inspection thoroughly of water quality of dialysis for safety of hemodialysis patients.
The ME Center Division provides clinical technical support for cardiac function tests, coronary angiography, interventional treatment, electrophysiological tests, ablation therapy, pacemaker implantation, etc in adults, children and post-heart transplantation patients in the Clinic of Radiology. An on-call system is used at night and on holidays.
Support is provided for ventricular assist devices, including presence at attachment and implantation, maintenance, and education for patients. After attachment and implantation, the Surgery Division and ME Center Division cooperate to provide clinical technical support, because patients receive post-surgical management in the Intensive Care Unit, and depending on their condition may be transferred to the CVCU or general ward for hospitalized management.
An on-call system is used at night and on holidays.
Clinical technical support is provided for heart-lung machines used in cardiovascular surgery performed by the Surgical Center. An on-call system is used at night and on holidays. The Surgery Division and ME Center Division cooperate to provide clinical technical support.
The ME Center Division provides clinical technical support for VAD and blood purification, in the Heart Center including CVCU and CCU, and maintenance of ventilators, peripheral devices, etc.
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