What Are The Most Common Pieces Of Equipment Used In Hospitals With Which Nurses Should Be Familiar?
Vital Signs Monitor
A vital signs monitor is one of the most common pieces of equipment used in a hospital. It is used to check temperature, blood pressure, pulse, and oxygen saturation. There are a manual sphygmomanometer and stethoscope that can be used to check or verify an electronic blood pressure reading. It is very important to assure that the appropriate size cuff is used for an accurate measurement. Always verify using an alternate or manual method when in doubt about the accuracy of any electronic reading.
ECG Monitor
Another common piece of equipment used is a continuous electrocardiograph that displays one or multiple leads of the ECG. These devices also may measure many other cardiac related variables. The other cardiac related variables are rhythm disturbances and data that may indicate cardiac medication toxicity. It’s very important to understand that the accuracy of these devices are directly related to accuracy of the placement of electrodes. Understanding anatomy and electrophysiology is important to know where and how to place these electrodes. Newer ECG monitors are capable of monitoring 15 or 18 leads and can continuously monitor for cardiac ischemia and damage. This is compared to the traditional ECG monitors which monitor 12 leads.
Defibrillator
A device that can be used to convert abnormal heart rhythms is called an electronic defibrillator, monitor, pacemaker. There are various models but they all do basically the same. They convert an abnormal rhythm to a normal rhythm. It is very important that the nurse caring for patients understands how this device operates and how and when to use it. This often requires special education and skill verification.
Mechanical Ventilator
Patients that have a secured airway and are intubated may be on a mechanical ventilator. While ventilator management may or may not be within the scope of practice of the bedside nurse (generally determined facility by facility), it is certainly important for the attending nurse to know how to manage ventilation and oxygenation of the critically ill or injured patient. This means recognizing incorrect placement or displaced airway devices, malfunction of the mechanical equipment (ie. Ventilator), or loss of power or gas supply. Basic airway management is a critical skill all nurses must learn and perform.
Glucometer
Devices that check or monitor glucose are also important to understand and operate. There must be regular testing and controls run on this equipment to assure its accuracy and have confidence in the results. As with any test, if the results are significantly high or low, it should be repeated or checked by another method.
IV Pumps
Many patients in the hospital may also have intravenous access for medication administration. There are many types and manufactures of IV pumps that control the rate and volume of fluid and medication administration. In most facilities, gone are the days of manually calculating the number of drops per minute in a volume chamber to calculate the dose of a medication to administer. Smart pumps now require the dosage order, concentration of medication and automatically sets the rate of administration. This requires the nurse be very familiar with how to program and set the variables on the pump for accurate medication administration.
PCA Pump
Another device that many patients may have is a patient controlled analgesia, or PCA, pump. These pumps are set up with a syringe of medication and then the nurse will enter the variables of the patient demand dose, how frequently that dose may be given and the maximum amount of medication that may be given over a period of time.
Enteral Feeding Tube Pump
Patients that can not eat or orally consume nutrition may have a feeding tube placed into the stomach or through the stomach into the small intestine. Patients receiving tube feeding with a pump must be monitored for nausea and vomiting and intolerance to this type of nutrition.
What Should I Do If I Do Not Understand How To Use And Operate Any Of These Devices?
The hospital should have policies and procedures that assure equipment competency and skill verification. However, when in doubt, ask for help. Never assume that you know how to operate a piece of equipment when you don’t.
What Should I Do If A Piece Of Equipment Fails To Perform As Expected?
You should immediately notify your supervisor and request a replacement. Second, tag the malfunctioning piece of equipment as defective so it is not used on any other patients until repaired by Clinical Engineering. If any patient is harmed by a malfunctioning piece of equipment, assure that it is kept just as it is – do not erase any memory or change any settings.
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