Maintenance Program for Medical Facilities -Part I - Utility Systems Management Plan

Part I - Utility Systems Management Plan

Purpose:

The purpose of this policy is to create a Utility Systems Management Plan for the hospital.

Utility systems provide essential services that are required by Central Hospital to support its mission of top-quality patient care, excellence in teaching and advances in research, while utilizing its resources in an efficient and cost effective manner. This document identifies the scope and overall organization of the Utility Management Plan utilized by the Maintenance Department to assure that these essential services are always available.

The Maintenance Department reviews the Management Plan on an annual basis for objectives, scope, performance, and effectiveness. This annual review is submitted for review and approval. The Maintenance Department provides Utility Management services for hospital operations located in the following facilities:

  1. All hospital areas
  2. All clinic areas
  3. All office areas


Maintenance and Testing of Utility Systems / Components:

Drawings, specifications, maintenance manuals are kept in the Maintenance Administration office. System specific manuals and drawings are kept in the associated maintenance files.

Detailed descriptions of maintenance and operating plans are maintained in the Maintenance and Service Manual, and kept in the Maintenance computer files.

PPM tasks are determined and scheduled utilizing recommendations, industry standards, current experiences, and evaluations, not to exceed annually.

Systems are installed and tested according the manufacturer's recommendations, codes and standards prior to use.


Inventory:

The following is a list of systems/ components covered by the Utility Management Plan:

  • Electrical system
  • Elevators
  • Generators
  • Refrigerators/ Freezers
  • Air conditioning system
  • Medical gas system
  • Medical suction/ vacuum
  • Domestic water system, including water pumps
  • Fire water system, including fire pumps
  • Boilers
  • Plumbing
  • Low current and communication system
  • Pavement & Ground
  • Hospital building and Ancillaries
  • Sewage and Garbage Disposal systems
  • Kitchen equipments
  • Laundry


Responsibilities:

The following addresses the primary areas of support as it relates to the Utility Management Plan. The Maintenance Department provides Environment of Care support to these areas. The following summarizes the key responsibilities covered by the plan.

1. Maintain utility system component inventory

2. Ensure routine maintenance is performed in a timely manner.

3. Promote a safe, controlled, comfortable environment of care.

4. Maintain reliable utility systems.

5. Maintain reliable life safety systems.

6. Identification of a maintenance provider for each component and assure this service is provided within an appropriate time period.

7. Provision for emergency repair service on a 24-hour basis.

8. Assess utility failures to minimize occurrences.


Performance Improvement:

The Director of General Support Services, along with the Maintenance Manager, is responsible for Performance Improvement, as it relates to the Utility Management Plant.

Maintenance Department management participates in the Infection Control Committee, and various financial meetings. This is a collaborative effort that provides information, cooperation, and resources to make improvements in the environment of care.

Specific responsibilities may be delegated to other members of the Maintenance staff as appropriate to assist in developing indicators, collection systems, reviewing and evaluating data, etc.


Utility Failure and Emergencies:

The Maintenance and Service Guide has specific plans for utility failures and emergencies. This plan is available in the Maintenance Office.

Utility Equipment Failure Reports are compiled and evaluated by the Maintenance office. Summaries of these reports are submitted on a monthly basis.


Incident Reporting:

Incident reports are completed on situations that resulted in injury or had a significant potential to cause an injury to patients or visitors. These reports are sent to Quality Assurance Management/ Risk Management for evaluation. Quality Assurance sends incident reports that are applicable to the facilities to the General Support Services Director. The General Support Services Director reviews pertinent reports to identify changes that may be required to prevent a re-occurrence of the situation.


Competency:

Training

Maintenance Department new employees go through departmental specific and on-the-job training.


  1. Utility systems capabilities, limitations, and special applications.
  2. Emergency system and failure.
  3. Information and skills necessary to perform assigned maintenance responsibilities.
  4. Safety training

Validation

  1. All maintenance staff members are evaluated annually for performance and job knowledge.
  2. Certifications
  3. Licensing


PART I - The Periodic Preventive Maintenance Program:


SECTION 1 - The Periodic Preventive Maintenance Program for the Electrical System is supported by trained/ specialized staff/ contractor, and maintenance records are documented.


1.1 Procedure:

1.1.1 The schedule for the periodic preventive maintenance for the electrical system in general, and its related electrical equipments include the following:


  • PPM for the Electrical System (General)
  • PPM for Low Voltage Switchgear, Switchboards, and Panelboards
  • PPM for Transformers
  • PPM for Motor Starters
  • PPM for Automatic Transfer Switches
  • Servicing of Circuit Breakers
  • Thermographic Inspection of Circuit Breakers


1.1.2 Electrical outlets shall be tagged and marked clearly for voltage (110/220V) in order to be readily identifiable.The cover plates for the electrical outlets or the electrical outlets themselves supplied from the emergency system, shall have a distinctive color or marking so as to be readily identifiable.

1.1.3 Main and feeder circuit breakers shall be inspected annually and a program for periodically exercising the components shall be established according to manufacturer's recommendation. Thermographic inspection or infrared test shall be conducted on all main current carrying components for hot spots that may indicate overload conditions or loose connections.

  • · Operating Room
  • · Laboratory
  • · Intensive (Critical) Care Unit
  • · Alarm Systems
  • · Blood Bank (Blood Storage)
  • · Medical Gas System


1.2 Job Description of Electrical Section staff:

1.2.1 Position: Electrical Engineer

Duties and Responsibilities:


  • · Reports to the Maintenance Manager
  • · Overall responsible for the maintenance and operation of the electrical system, electronics and communication systems, alarm systems, and elevators located in the hospital complex. This would include the electrical equipments and electrical system components of all non-medical equipments and utilities.
  • · Responsible for the electrical technicians and electricians assigned in the electrical section.
  • · Assigns the technicians and electricians to their regular specific assignments, as in the operation of electrical equipments and periodic preventive maintenance.
  • · Assigns and dispatch technicians or electricians to work on problem or failure of any electrical equipment, noticed during regular inspection or reported by other departments.
  • · Make sure that prompt actions and correct procedures are followed by his men during operation, maintenance, troubleshooting, and repair of equipments.


Qualifications:


  • · Bachelor of Science in Electrical Engineering
  • · At least five (5) years working experience in the operation and maintenance of electrical systems including power generation, electronics and communication systems, alarm systems and elevators, preferably in a 100-bed hospital or bigger.
  • · Good command of English, both written and oral is a must. Knowledge in Arabic is preferable.
  • · Good computer knowledge is a must.


1.2.2 Position: Electrical Technician / Electrician

Duties and Responsibilities:


  • · Reports to the Electrical Engineer
  • · Responsible for the maintenance and operation of the electrical system located in the hospital complex. This includes the electrical equipments and electrical system components of all non-medical equipments and utilities.
  • · Work on regular specific tasks assigned by the Electrical Engineer.
  • · Work on all tasks regarding any problem or failure of electrical equipments, noticed during regular/ routine inspection or reported by other sections/ departments.
  • · Act promptly and follow correct and proper procedures during operation, troubleshooting, maintenance, and repair of equipments.
  • · Work on any other tasks assigned by the Electrical Engineer.


Qualifications:


  • · Two-year technical course as Electrician or Diploma in Industrial Electricity.
  • · At least two years working experience as electrical technician or electrician, preferably in medical facilities.
  • · Knowledge in electrical power distribution and controls is preferable.
  • · Able to communicate in both English and Arabic.
  • · Able to write technical reports.



1.3 Attachments:


  1. Infrared test results for operating rooms circuit breakers.
  2. Infrared test results for laboratory circuit breakers.
  3. Infrared test results for the intensive care unit circuit breakers.
  4. Infrared test results for the alarm systems circuit breakers.
  5. Infrared test results for blood bank circuit breakers.
  6. Infrared test results for the medical gas system breakers.
  7. Education, training and work experience certificates of electrical technicians/ electricians
  8. Electrical System PPM documents



1.4 PERIODIC PREVENTIVE MAINTENANCE SCHEDULE FOR ELECTRICAL SYSTEM

1.4.1 Equipment: Electrical System (General)


Annually

  1. Inspect secondary electrical distribution system, including low voltage switchgears, switchboards, panelboards, transformers, motor starters, and automatic transfer switches.
  2. Remove debris, dirt, and other foreign objects from all components, housings, cabinets, panels, etc..
  3. Torque all electrical connections to design value.
  4. Verify equipment grounding and associated neutral where applicable.
  5. Conduct infrared test on all main carrying equipment for hot spots that may indicate overload conditions or loose connection.
  6. Using calibrated instruments, calibrate ammeters, voltmeters, etc.



1.4.2 Equipment: Electrical System – Low Voltage Switchgear, Switchboards, and Panelboards

Semi-annually

Inspect solid electrical insulation for discoloration and degradation.

Annually

Inspect barriers and shutters for physical damage.

  1. Test bus insulation.
  2. Service circuit breakers.
  3. Inspect breakers' current carrying components for discoloration that may indicate overheating. Correct as required.
  4. Test power circuit breakers. Perform test operations to prove correct actuation of breakers' trip and close components, including spring charging motors, trip solenoids, indicating targets, etc.
  5. Test molded circuit breakers. Perform overcurrrent test on critical load breakers to prove correct actuation of breaker's trip and close components.
  6. Perform insulation resistance test on phase-to-phase and phase-to-ground using a megohmmeter.
  7. Prove circuit breaker operation by actuation of each associated protective device.
  8. Prove circuit breaker operation by actuation of each breaker's manual control switch or handle.



1.4.3 Equipment: Electrical System – Transformers

Annually


  1. Inspect forced cooling system equipment for damage, etc.
  2. Operate system by simulating high temperature at cooling devices.
  3. Verify transformer alarms.
  4. Clean transformer external surfaces.



1.4.4 Equipment: Electrical System – Motor Starter

Annually


  1. Manually operate switches and circuit breakers to verify correct operation.
  2. Operate starting unit using all manual and automatic control devices to ensure correct operation.
  3. Verify interlocking action with other associated equipment.
  4. Verify correct indicating light operation.
  5. Verify equipment alarms.



1.4.5 Equipment: Electrical System – Automatic Transfer Switches


Annually


  1. Inspect, operate, adjust, and lubricate mechanical linkages.
  2. Verify operation of mechanical interlocks.
  3. Inspect and dress current carrying contacts in accordance with manufacturer's recommendations.
  4. Test automatic transfer switches. Perform insulation resistance test on each phase-to-phase and phase-to-ground using a megohmmeter.
  5. Perform contact resistance test.
  6. Prove correct operation of the transfer switches by manually initiating transfers in both directions.
  7. Verify starting generators where applicable.
  8. Verify correct indicating light operation.
  9. Verify equipment alarms.



SECTION 2 - The Periodic Preventive Maintenance (PPM) program for generator(s) is supported by trained/ specialized staff/ contractor, and maintenance records are documented.


2.1 Job description of Generator Section staff:

2.1.1 Position: Generator Engineer

Duties and Responsibilities:

  • Reports to the Maintenance Manager.
  • Overall responsible for the operation and maintenance of emergency/ standby generators for the hospital.
  • Responsible for the generator technicians/ operators.
  • Assign and supervise the technicians/ operators on their regular/ routine specific assignments, regarding the operation and maintenance of the generators, which include the weekly no-load tests, monthly tests with load for thirty minutes, and the annual tests at one hundred percent (100%) of full rated capacity.
  • Make sure that the periodic preventive maintenance of generators is done on time, and the weekly, monthly, and yearly test runs are duly complied with.
  • Make sure that records of the periodic preventive maintenance performed, and the weekly, monthly, and yearly tests results are compiled and kept in file for ready reference and review.
  • Make sure that prompt action and correct procedures are followed during the operation, maintenance, troubleshooting, and repair of generators.

Qualifications:

  • Bachelor of Science in Mechanical Engineering or Electrical Engineering.
  • At least five (5) years working experience in electrical power generation as Power Plant Engineer/ Supervisor, preferably in a 100-bed hospital or bigger.
  • Good command of English, both oral and written is a must. Knowledge in Arabic is preferable.
  • Able to write technical reports in English and/or Arabic.
  • Good computer skills is a must.


2.1.2 Position: Generator Technician/ Operator

Duties and Responsibilities:

  • Reports to the Generator Engineer
  • Responsible for the operation and maintenance of emergency/ standby generators for the hospital.
  • Perform regular/ routine specific assignments, regarding the operation and maintenance of the generators, which include the weekly no-load tests, monthly tests with load for thirty minutes, and the annual tests at one hundred percent (100%) of full rated capacity.
  • Perform the periodic preventive maintenance on time, and accomplish the weekly and monthly tests, and assist in the yearly test runs of generators.
  • Accomplish records of the periodic preventive maintenance, and the weekly, monthly, and yearly tests for the generators.
  • Act promptly and follow correct procedures during the operation, maintenance, troubleshooting, and repair of generators.

Qualifications:

  • Diploma in Diesel Mechanics or a two-year technical course in industrial electricity.
  • At least two (2) years working experience in maintenance and operation of electric power generators, preferably in a medical facility.
  • Able to communicate in English and Arabic is a must.
  • Able to write technical reports in English and/or Arabic.
  • Computer knowledge is preferable.



2.2 Procedure:


2.2.1 The Periodic Preventive Maintenance Schedule of Generators


Weekly


  1. Check engine oil level, oil pressure and temperature.
  2. Check coolant level and temperature.
  3. Check for oil, fuel, and coolant leakages.
  4. Clean engine outside surface from dust and oil.
  5. Clean control panel from dust.
  6. Check all terminals for tightness.
  7. Check battery volts.
  8. Check battery electrolyte level.
  9. Check frequency and generated voltage.


Monthly


  1. Check oil and fuel filters.
  2. Check for abnormal vibration, noise, and smell.
  3. Check for fuel or water presence in oil.
  4. Check radiator fan motor.


Semi-Annually


  1. Check V-belts.
  2. Check for loose bolts and nuts.
  3. Check/ clean air filter.
  4. Check fuel injection pump.


Annually

  1. Change lubricating oil.
  2. Change oil and fuel filters.


2.2.2 The hospital's emergency power (in case of main power interruption) is tested on station load for thirty minutes monthly and the test results are documented. The emergency power covers at least the following areas:

· Operating Room

· Labor and Delivery

· Critical Care Units

· Alarm System

· Fire Pumps

· Blood Storage

· Medical Gas System

· Kitchen Refrigerators and Freezers

· Elevators

· Escape Routes / Corridors


2.2.2.1 Testing Procedure:


1) A 30-minute generator test with load would be scheduled every month.

2) The concerned staff assigned or responsible to the affected zones/ areas/ departments / facilities would be informed at least one hour before the test is initiated.

3) The concerned staff will make necessary preparations in case some untoward incident happens in the duration of the test, like for example; a generator failure, an ATS failure or any other equipment failure of the power generating system.

4) The generator section staff along with the electrical section staff will make the necessary preparations for the test.

5) When everything is ready, a power failure would be simulated by switching off the main incoming breaker to the Automatic Transfer Switch (ATS) supplying the zones/ areas to be tested.

6) A system of events would then be noted and recorded in a Load Test Report which includes:

a) Event timing


  • · Time when the main power supply was cut off
  • · Time when the main supply was resumed
  • · The total duration of the test
  • · Time duration from power cut off to generator loading
  • · Generator cool down duration


b) Operation data

  • · Peak power supplied during test
  • · Station capacity

c) Operation control status, whether acceptable or not

d) Equipment status

  • · Load taken by the generator being tested
  • · Operational status of the other generators in the plant

e) Auxiliary status


  • · Operational status of the fuel supply system
  • · Operational status of the power house ventilation system
  • · Operational status of the cooling system
  • · Operational status of the control voltage supply


f) The supply storage status

  • · Fuel supply
  • · Lube oil supply

g) Power change-over status of equipments, whether it is normal, delayed, or failed


  • · Automatic transfer switch
  • · Generator
  • · Electrical distribution network
  • · Others



2.2.3 The hospital emergency power generator is tested without load on a weekly basis for ten minutes, and test results are documented.


2.2.3.1 Testing Procedure:


1) The generator operator will prepare the generator set to be tested by checking fuel, lube oil, and cooling water levels.

2) The unit would then be started manually and allowed to run for ten minutes without load.

3) The system parameters of pressure, temperature, engine speed, generator voltage, and frequency shall be noted and recorded in the Weekly Test-Run (No-Load) Report.

These are:

· Diesel fuel tank level

· Fuel pressure before filter

· Fuel pressure after filter

· Radiator cooling water level

· Cooling water inlet pressure

· Cooling water inlet temperature

· Cooling water outlet temperature

· Lube oil sump tank level

· Lube oil inlet pressure

· Lube oil inlet temperature

· Exhaust temperature

· Intake air temperature

· Engine speed

· Battery voltage

· Generator voltage

· Frequency

4) Any abnormality during the test shall be comprehensibly noted in the "Remarks" column.



2.2.4 The hospital emergency power generator is tested annually on load bank for four (4) hours at 100% load, results are documented.

A specialized contracting company would be contacted to perform the test. Testing should be done for each of the hospital emergency power generators, one at a time, at 100% of rated capacity for a minimum of four (4) hours.


2.2.4.1 Testing Procedure:

1. While the hospital power requirement is being supplied by normal power, the emergency generator to be tested is isolated from the electrical distribution system.

2. A load bank of resistors would then be connected to the power output of the emergency generator.

3. Load would then be increased gradually in steps, while continuously monitoring both the electrical and mechanical system parameters of the power generating set being tested, until it reaches 100% of full rated capacity of the said unit.

4. At 100% of full rated capacity, the generator must be allowed to run continuously for at least four (4) hours, unless some abnormal conditions are observed during the process, in which case, the load bank test would be concluded as a failure, and the emergency power generator tested will be considered as failed.

Test results would be documented. The contracting company will issue a "Generator Load Test Certificate", duly signed and stamped officially.


2.3 Attachments:

· Monthly Load Test Reports

· Emergency Generator Weekly No-Load Test Reports

· Load bank test results

· Generator Load Test Certificate

· Periodic preventive maintenance records for generator.

· Electrical system inspection records.

· School, training, and work experience certificates of generator technicians/ operators.


SECTION 3 - The Periodic Preventive Maintenance (PPM) program for Heating, Ventilating, and Air Conditioning (HVAC) system is supported by trained/ specialized staff/ contractor, and maintenance records are documented.

The HVAC section adopts the American Society of Heating, Refrigeration and Air Conditioning Engineers (ASHRAE) standards/ equivalent standards for:

· Control of air quality by doing the following:

· Cleaning/ replacement of filters

· Cleaning of diffuser

· Cleaning ducts


3.1 Job Description of Mechanical Section staff:

3.1.1 Position: Mechanical Engineer

Duties and Responsibilities:

· Reports to the Maintenance Manager

· Overall responsible for the maintenance and operation of all mechanical systems; heating, ventilating, and air conditioning systems; refrigeration system; medical gas system; domestic water system including the R.O. plant; and the plumbing and sewage systems located in the hospital complex. This would include the mechanical equipments and mechanical system components of all non-medical equipments and utilities.

· Responsible for the mechanical technicians and mechanics assigned in the mechanical section.

· Assigns the technicians and mechanics to their regular/ routine specific assignments, as in the operation of mechanical equipments and the periodic preventive maintenance tasks.

· Assigns and dispatch technicians or mechanics to work on problem or failure of any mechanical equipment, either noticed during regular inspection or reported by other section/departments.

· Make sure that prompt actions and correct procedures are followed by his men during operation, maintenance, troubleshooting, and repair of equipments.

Qualifications:

  • Bachelor of Science in Mechanical Engineering.
  • At least five (5) years working experience in operation and maintenance of mechanical systems, preferably in medical facilities.
  • Good command of English, both written and oral. Knowledge in Arabic is preferable.
  • Computer knowledge is a must.


3.1.2 Position: Heating, Ventilating, and Air Conditioning Technician/ Mechanic

Duties and Responsibilities:

· Reports to the mechanical engineer.

· Responsible for the maintenance and operation of the HVAC and refrigeration systems located in the hospital complex.

· Work on regular specific tasks assigned by the mechanical engineer.

· Work on all tasks regarding any problem or failure of HVAC and refrigeration equipments, either noticed during regular/ routine inspections or reported by other sections/ departments.

· Act promptly and follow correct and proper procedures during operation, troubleshooting, maintenance, and repair of equipments.

· Work on any other tasks assigned by the mechanical engineer.

Qualifications:

· Diploma in Refrigeration and Air Conditioning.

· At least two (2) years working experience in operation and maintenance of refrigeration and air conditioning systems, preferably in medical facilities.

· Able to communicate in English and Arabic is a must.

· Able to write reports in English.


3.2 Procedure:


3.2.1 The Periodic Preventive Maintenance Schedule of HVAC Systems

3.2.1.1 For Central/ Package Type Air Conditioning System

Monthly


  1. · Clean aluminum/ inlet air filters.
  2. · Check motors, compressors, fans, blowers, and drive system components (belt, pulley, etc) for damage, wear, and failure.
  3. · Check safety controls (pressure and temperature switches) for correct functioning and efficiency.
  4. · Check electrical components (contactors, relays, overload or over current protection switches and fuses) and wiring for possible replacement or connection tightness.
  5. · Check condensate drain for clog or leak.







Annually


  1. Clean air ducts and diffusers.
  2. Clean high efficiency particulate air(HEPA) filters/ bag filters.
  3. Clean condenser coils and evaporator coils.
  4. Inspect the unit duct connections to ensure they are physically sound and sealed to the unit casing.
  5. Inspect the unit mounting support to see that it is sound.
  6. Inspect the unit to ensure there is no obvious deterioration.
  7. Inspect exhaust fan. Check motor/fan drive.


3.2.1.2 For Window and Split Type Air Conditioner

Weekly

  • Check anti-bacteria air filter. Clean as necessary.

Monthly

  • Clean air filter.
  • Check condensate drain for clog or leak.

Yearly

  • Clean condenser coil and evaporator coil.
  • Clean safety controls.
  • Check electrical components (selector switch, overload relay, solenoid valve) and wiring for possible replacement or tightness.
  • Check fan motor, blower, compressor and drive system components (belt, rubber coupling) for wear, damage, or failure.
  • Inspect the unit mounting support to see that it is sound.
  • Inspect the unit to ensure there is no obvious deterioration.


3.2.2 Control of temperature and humidity regularly at least in the following areas:

· O.R.

· Recovery Room

· Nursery

· I.C.U.

· Sterilized Storage Supply

· Patient Room


3.2.2.1 Responsibility:

A. Control of room temperature must be maintained by staff assigned to that area, depending on the request/ needs of the occupants.

B. Concerned section staff will notify HVAC by calling 2295, or make a job request addressed to the maintenance department, whenever the room temperature varies widely from the desired set point value.

C. HVAC will respond immediately in order to correct the problem.

D. HVAC will make a record of the problem and the actions done to correct it.

E. HVAC shall make regular rounds/ checks in all air-conditioned rooms/areas to monitor temperature and humidity, and make necessary adjustments as required..

3.2.2.2 Control of temperature

A. Central/ Package air conditioning units must have the thermostats located in a place easily accessible to the occupants of the area/ zone being served by the unit, and bears the closest representative temperature for the entire area.

B. Desired temperature is achieved by adjusting the thermostat at the desired set point value depending on the needs/ requirements of the occupants.

C. Rooms must not be overcooled, as this is not good for health and wastes electricity.

D. Avoid opening doors and windows as much as possible, to keep the cool air in the room.

E. Do not let direct sunshine enter the room when the air conditioner is in operation. Keep blinds or curtains closed.

F. Ventilate the room occasionally. Since windows are kept closed, it is a good idea to open them and ventilate the room every now and then, whenever and wherever it is allowed.

3.2.2.3 Control of humidity

A. Humidity controllers are usually integrated with temperature controllers in one controller unit.

B. Humidity is controlled by adjustment settings with the integrated temperature/humidity remote controllers supplied with the unit.

3.2.3 Control of positive, negative, and equal pressure and air flow every three (3) months at least in the following areas:

· O.R.

· Labor and Delivery

· Isolation Room(s)

· Intensive/ Critical Care Unit(s)

· Clean Utility

· Dirty Utility

· Janitorial Closet

· Laboratory


3.2.3.1 Purpose:

Negative Pressure Isolation Rooms maintain a flow of air into the room, thus keeping contaminants and pathogens from reaching surrounding areas. The most common application in the health industry today is for Tuberculosis (TB) rooms. The infectivity of TB is extremely high and these rooms are essential to protect health workers and other patients.

Positive Pressure Isolation Rooms maintain a flow of air out of the room, thus protecting the patient from possible contaminants and pathogens which might otherwise enter. The most common application today is HIV Rooms and rooms for patients with other types of immunodeficiency. For such patients it is critically important to prevent the ingress of any pathogens, including even common fungi and bacteria which may be harmless to healthy people.

A uniform procedure to smoke test negative pressure rooms should be established and ensure these rooms are maintainedat negative pressure relative to the surrounding areas.


3.2.3.2 Responsibility:

A. Rooms maintained under negative pressure in the following locations will be tested by staff assigned to that area:

Assigned staff/ Testing frequency

Operating Rooms

O.R. staff/ As needed

HVAC staff/ Every 3 months

Labor and Delivery

Labor and Delivery staff/ As needed

HVAC staff/ Every 3 months

Intensive Care Unit

I.C.U. staff/ As needed

HVAC staff/ Every 3 months

Clean Utility

HVAC staff/ Every 3 months

Dirty Utility

HVAC staff/ Every 3 months

Janitorial Closet

HVAC staff/ Every 3 months

Microbiology, TB Lab

Laboratory staff/ As needed

HVAC staff/ Every 3 months

Isolation Rooms

HVAC staff/ Every 3 months

Other Negative Pressure Rooms

HVAC staff/ Every 3 months


B. Only properly trained staff members shall smoke test a negative pressure room. Contact Infection Control for training needs.

C. Concerned section staff will contact the Infection Control, if there are in-patient rooms occupied by known or suspected infectious patients. Infection Control will be responsible for the testing and recordkeeping for these rooms. A list of negative pressure rooms are provided in Appendix A.

D. If assigned staff determines a room is not under negative pressure, they will notify HVAC immediately by calling 2295. HVAC will respond immediately in order to correct the air pressurization issue.

E. Assigned staff will retest the room after HVAC has made the corrections.

F. Assigned staff will notify Infection Control, by phone, when all rooms have been successfully tested.

G. Assigned staff will maintain all testing documentation. HVAC will maintain all repair documentation.

H. HVAC will smoke test all negative pressure room every 3 months as per Hospital Facility

Management and Safety Policy & Procedure to ensure that negative pressure is maintained. HVAC will maintain these test records.


3.2.3.3 Procedure:

For Negative Pressure Rooms, the CDC recommends 6-12 air changes per hour (ACH) for TB rooms. An ante room is always recommended, as this provides a barrier between the TB room and hallways and limits the impact of opening doors and traffic. The exhaust air is normally filtered through a HEPA (High Efficiency Particulate Air) filter before being exhausted to the outside, where it is ultimately rendered harmless by natural elements. Air which is recirculated within the room is also normally filtered. Ultraviolet Germicidal Irradiation (UVGI), commonly known as UV light, may be used to augment HEPA filters, but cannot be used in place of HEPA filters, as their effectiveness on air streams is limited.

The exact air differential which is required to be maintained is nominal only, as it merely indicates the air flow direction. It is sometimes stated as 0.001 "wg, but this is NOT a pressure which is practical to measure, and therefore other criteria are given such as maintaining an inward velocity of 100 fpm, or exhausting 10% of the airflow, or exhausting 50 cfm more than the supply. The exact criteria will always be dependent on both the size and the airtightness of the subject facility.

For Positive Pressure Isolation Rooms, the design criteria is similar to the Negative Pressure Isolation Rooms.


Testing Procedure:

  1. Negative pressurization will be monitored using a smoke trail test. The smoke tube is to be held near the bottom of the door and approximately two inches in front of the door. A small amount of smoke is generated by gently squeezing the bulb. The smoke tube should be held parallel to the door, and the smoke should be issued from the tube slowly to ensure the velocity of the smoke from the tube does not overpower the air velocity.
  1. If the room is at negative pressure, the smoke will travel under the door and into the room. If the room is not a negative pressure, the smoke will be blown outward (positive pressure) or will stay stationary (equal pressure).
  2. This test must be performed while the door is closed, and the windows in the room must be closed. If the room shares a common bathroom with an adjoining room, the bathroom doors to both rooms must be closed. If room air cleaners are being used (including fume hoods or bio-safety cabinets) they should be running.
  3. If the room has an anteroom, test the pressure differential from the corridor to the anteroom, and from the anteroom to the room.
  4. Staff must don respiratory protection (e.g. N95 respirator) in the corridor prior to entering the anteroom.


SECTION 4 – The Periodic Preventive Maintenance Schedule of Refrigerator and Freezer


Monthly

  • Check safety controls (pressure and temperature switches) for correct functioning.
  • Check electrical components (contactor, overload or over current protection relay and fuse)and wiring for possible replacement and tightness.

Quarterly

  • Check motors, compressors, fans, blowers and drive system components (belt, pulley, rubber coupling) for damage, wear, and failure.

Annually


  • Clean condenser coils.
  • Inspect the unit mounting support to see that it is sound.
  • Inspect the unit to ensure there is no obvious deterioration.
  • Check bacterial filter and exhaust drainage to ensure that there is no liquid


4.1 ATTACHMENTS: PPM records for Refrigerators and Freezers


SECTION 5 - The Periodic Preventive Maintenance (PPM) program for Medical Gas is supported by trained/ specialized staff/ contractor, and maintenance records are documented.

5.1 Job description for Medical Gas Operator:

Position: Medical Gas Operator

Duties and Responsibilities:

  1. Reports to the Mechanical Engineer.
  2. Responsible for the operation and maintenance of medical gas system including medical air compressor, medical air dryer, medical vacuum, and manifold control systems.
  3. Work on regular specific tasks assigned by the mechanical engineer.
  4. Work on all tasks regarding any problem or failure of medical gas system, noticed during regular/ routine inspection or reported by other sections/ departments.
  5. Act promptly and follow correct and proper procedures during the operation, maintenance, troubleshooting, and repair of medical gas system equipments.
  6. Work on any other tasks assigned by the Mechanical Engineer.

Qualifications:

  1. Two-year course in Trade school as Mechanical Technician, or Diploma in Refrigeration and Air Conditioning.
  2. Good knowledge in industrial electricity is a must.
  3. At least two (2) years working experience in the operation and maintenance of medical gas systems.
  4. Able to communicate in both English and Arabic is a must.
  5. Able to write reports in English.


5.2 Procedure:

5.2.1 The Periodic Preventive Maintenance Schedule for Medical Gas System

5.2.1.1 Medical Vacuum

Weekly

  • Inspect for oil leakage.
  • present.
  • Check bacterial filter differential pressure gage (50 mm Hg max.)

Semi-annually

  • Clean the gas ballast filter, inlet mesh, and filter inserts.
  • Inspect flexible hoses for damaged braiding, loose connections, and corrosion.
  • Drain vacuum reservoir.

Annually

  • Change lubricating oil.
  • Check motor/ pump drive rubber coupling.
  • Change oil separator filter elements.


5.2.1.2 Medical Air Dryer

Weekly

  • Check for water or air leaks.
  • Check for abnormal noise.
  • Check the pressure drop over the filters (50 mm Hg max.)
  • Check if all drains are working properly.
  • On filters with automatic drain valves, check liquid level in the sight glass.

Monthly

  • Verify air quality delivered by the unit.

Semi-annually

  • Check for damaged wiring or loose connections.
  • Service the automatic assembly of the dryer.
  • Check the elements of the filter. Replace if worn, or when the pressure drop reaches approx. 0.35 bars.
  • Check electrical components and wiring (for possible replacement and tightness).

Every 3 years

  • Replace the desiccants of the entire unit.


5.2.1.3 Medical Air Compressor

Weekly

  • Check oil level.
  • Check for air or oil leaks.
  • Check oil temperature.
  • Check pressure differential gauge indications.
  • Drain condensate from receiver.

Quarterly

  • Clean air filters.
  • Clean air/oil cooler external.
  • Clean auto drains.

Semi-annually

  • Check electrical components and wirings (for possible replacement or tightness.)
  • Clean electrical motors external.

Annually

  • Change compressor oil.
  • Change air filter.
  • Change oil filter.
  • Change V-belts, if fitted.
  • Change separator elements.


5.2.2 Medical Gas System is regularly tested for:


  • · Pressure
  • · Leaks
  • · Functionality of valves, alarms, pressure gages, switches, etc.
  • · Emergency shut off valves at nurse station/ corridor are identified to indicate departments supplied.
  • · Labels to identify medical gas lines and directions are clearlymarked.
  • Emergency shut off valves at nurse stations and/or corridors should be marked to identify what type of medical gas and to which department they are supplying.
  • All medical gas lines should be labeled to identify the type of medical gas it is carrying and the direction to which it is supplying.



5.2.2.1 TESTING PROCEDURE:

Tubes, valves, fittings, station outlets, and other piping components in medical gas systems shall have been tested and cleared for the intended service whether for medical air, medical vacuum, nitrous oxide, or oxygen, by the manufacturer's agent/ installation contractor upon completion of installation. These piping components shall have been cleaned by the manufacturer prior to installation, except that fittings shall be permitted to be cleaned by a supplier or agency other than the manufacturer.

However, retesting and maintenance of non-flammable medical piped gas and vacuum systems should be performed regularly in accordance with NFPA recommendations, as follows:

Cylinder Supply System with Reserve Supply

The system should be checked dailyto assure that proper pressure is maintained and that the changeover signal has not malfunctioned.

Main-Line Pressure

The main-line pressure gage should be checked dailyto assure the continued presence of the desired pressure. Variation, either increases or decreases, should be investigated and corrected.

Medical Air Compressor Intake Location

Quarterly rechecking of the location of the air intake should be made to assure that it continues to be a satisfactory source for medical compressed air.

Medical Air Supply System

Proper functioning of the pressure gage and high-water-level sensor should be checked at least annually. Check the receiver drain daily to determine if an excessive quantity of condensed water has accumulated in the receiver. Check the automatic drain function.

Changeover Warning Signal – Manifold or Alternating Supply

As this is a routine signal that is activated and deactivated at frequent intervals, there is no need for retesting UNLESS it fails. If the reserve-in-use signal is activated because both units of the operating supply are depleted without prior activation of the changeover signal, it should be repaired and retested.

Reserve In Use Warning Signal

All components of this warning signal system should be retested annually. If test buttons are provided, audible and visual signals should be tested periodically (monthly) during the year.

Reserve Supply Low (Down to an average one-day supply)

All components of these signal warning systems should be retested annually. If test buttons are provided, audible and visual signals should be tested monthly.

Medical Air Master Alarm Panel

The medical compressed air system alarms should be checked at least annually.

Main Line Pressure Gage

The pressure gage should be checked on a daily basis to assure proper piping pressure. A change, increase or decrease, if noted, may give evidence that maintenance may be required on the line pressure regulator, and could thus avoid a problem.

Area Alarm Panel Pressure Gages

The pressure gage should be checked on a daily basis to assure proper system pressure. A gradual change, increase or decrease, if noted, will give an indication of a developing problem that could be avoided by preventive maintenance.

Shut-Off Valves

Shut-off valves should be periodically (annually) checked for external leakage by means of a test solution (e.g. soapy water) or other equally effective means of leak detection safe for oxygen use.

Station Outlets

Station outlets should be periodically (annually)checked for leakage and flow. Instructions of the manufacturer should be followed in making this examination.

5.3 Attachments:

· Medical Gas Test Records

· PPM Records for Medical Gas System

· Daily Checklist Records

· School, training, and work experience certificates of Medical Gas Operator.


SECTION 6 - The Periodic Preventive Maintenance (PPM) program for Water System is supported by trained/ specialized staff/ contractor, and maintenance records are documented for:


  • · Water is available 24 hrs/day, every day of the year, by checking the water level daily.
  • · The incoming water supply is checked regularly for at least the following, and results are monitored. Chemicals (once every six months) Bacteria (monthly)



6.1 Procedure:


  • The Water Treatment (R.O.) Plant Operator shall continuously monitor the proper operation of the plant by checking essential system parameters like pressures, temperatures, flow, and chemical and physical properties.
  • The Water Treatment (R.O.) Plant Operator shall monitor the availability of water supply by checking the raw water tank and product water tank levels.
  • All system parameters and water level readings shall be recorded by accomplishing the daily log sheet for the plant, and kept in file.
  • Water samples from the main water supply tank shall be submitted to the laboratory for microbial/ bacterial growth analysis monthly, and for chemical analyses, at least, bi-annually.



6.1.5 Periodic Preventive Maintenance Schedule of Domestic Water System, Including Water Pumps

Monthly


  • Look for leaks in exposed pipes and hoses. Signs of a leak include puddles of water and watermarks.
  • Check water reticulation system to make sure there is enough water pressure. Low water pressure can be a sign of sediment build up in the pipes and hoses.
  • Check domestic water pump if enough water pressure is delivered. Low water pressure could be caused by a defective inlet or outlet valve, a worn out impeller, or a defective pressure switch.
  • Check float switches and float valves for proper water level control.


Annually


  • Check the motor for any sign of overheating. Motor overheating could be caused by worn out bearings, dirty cooling fins or defective cooling fan. Re-grease motor bearings through the grease nipple, clean cooling fins, or replace cooling fans.
  • Check motor/pump drive. Check mechanical seal for wear.
  • Check the pipes and hoses to make sure that there aren't any cracks and that they are not brittle or leaking.
  • Clean water tanks of accumulated sediments and dirt.


6.2 ATTACHMENTS:

· Bacterial growth analysis reports

· Chemical analyses

· Daily Log Sheets for R.O. Plant

· PPM Records for Domestic Water System


SECTION 7 – The Periodic Preventive Maintenance Schedule for Fire Water System, Including Fire Pumps

Weekly


  • Run the fire pumps (for a minimum of 10 minutes for Electric-Driven pump, minimum of 30 minutes for Diesel-Driven pump) and observe if they are operating properly. Record suction and discharge pressures.
  • Visually check the pump packing glands for slight water discharge through the packing and adjust if necessary.
  • Check for unusual noise or vibration.
  • Check the packing boxes, bearings or pump casing for overheating.
  • Verify that all fire protection valves in the pump room are in the fully open position.
  • Ensure that all piping and valves should be free of leaks, and engine pressures should be within acceptable ranges.
  • Verify that the electrical systems are in the proper operating conditions.
  • For electric-driven pumps, verify that the controller lights, such as power on, transfer switch and isolating switch indicators, are illuminated.
  • The jockey pump start and stop pressure should be verified.


Monthly

For diesel-driven pumps:


  • Fuel tank should not leak and should be no less than two thirds full.
  • The controller selector switch
  • should be in the automatic position.
  • The battery voltage and charging
  • current readings should be in the acceptable range.
  • All battery pilot lights should be operable and in the appropriate position.
  • All alarm pilot lights should be off.
  • Oil levels should be verified to be within acceptable range.
  • Radiator system , if fitted, should be maintained with the appropriate coolant level.
  • Batteries should be checked to verify that the batteries' electrolyte level is within
  • acceptable range and that the terminals are free of corrosion.


Quarterly


  • Clean diesel fuel strainer/filter.
  • Clean cooling system strainer, if fitted.
  • Battery terminals should be cleaned and tightened.


Annually


  • Change diesel engine lubricating oil.
  • Lubricate pump bearings, mechanical transmission coupling, gear drive, and other
  • moving mechanical parts needing lubrication.
  • Electrical connections should be inspected and tightened as needed.
  • The fire pump coupling alignment should be checked.
  • Diesel engine fuel tank should be cleaned of any water and foreign material in the
  • tank.


7.1 - ATTACHMENTS: PPM records for Fire Water System


SECTION 8 – The Periodic Preventive Maintenance Schedule for Boilers

Monthly


  • Perform all flame safeguard and safety trip checks and record results in service report.
  • Check all hand hole plates and manhole plates for leaks at normal operating temperatures and pressures.
  • Troubleshoot any boiler system problem as requested by on-site personnel.


Semi-annually


  • Clean burner and burner pilot.
  • Check pilot electrode and adjust or replace.
  • Clean air damper and blower assembly.
  • Clean motor starter contacts and check operation.
  • Make necessary adjustments to burner for proper combustion and record all results in service report.


Annually


  • Open front and rear doors. Clean and vacuum fire side surfaces as required.
  • Inspect all refractory. Patch and wash coat as required.
  • Inspect all gaskets on front and rear doors and replace as necessary.
  • Remove low water cut-off controls, clean and inspect.
  • Remove all hand hole and man hole plates. Flush boiler with water to remove scale and sediment. Use scale removing chemicals if necessary.
  • Inspect feedwater tank. Clean as required.


8.1 ATTACHMENTS: PPM records for Boilers


SECTION 9 – The Periodic Preventive Maintenance Schedule for Plumbing System

Monthly


  • Look for leaks in exposed pipes, and hoses.
  • Check the flushing handle and inside parts of the toilet. Flush each toilet to make sure that it is flushing properly. Make sure the toilet water does not continue to run after flushing and make sure there is no sign of water on the floor around the toilet.
  • Turn on all the faucets to see if there is any water coming out of the handle and valves.


Annually


  • Check the hoses to make sure that there aren't any cracks and that the hoses are not brittle or leaking.
  • Look for signs of corrosion on pipes. Corrosion can cause leaks and bad pipe connection.
  • Test water pressure. Water pressure is with how much force the water comes out of sink faucets and shower heads.
  • Check each sink, shower and tub drain for the speed of drainage. Slow drainage usually indicates a clog in the drain or a blocked vent pipe.
  • Look for cracked tiles in the shower, around sinks, or near water pipes.
  • Push and pull on each toilet if it rocks or moves.
  • Drain the water heater to remove sediments that may have built up in it.


9.1 ATTACHMENTS: PPM records for Plumbing System


SECTION 10 – The Periodic Preventive Maintenance Program for Elevators (Lift)

Weekly

  • Check safety controls (limit switches, overload switches, micro switches, photo cells, brake sensors, etc.) for operation efficiency.
  • Check oil level on gear drive.

Monthly

  • Check electronic and electrical components (contactors, circuit breakers, relays, and fuses) and wirings for possible replacement and tightness.

Quarterly


  • Check distance of the rope protection clamp.
  • Check the brake air gap.
  • Visual inspection of the mounting screws on the housing, brakes, and traction sheave. The locking compound must be free of damage.
  • Inspect wire rope for any sign of damage, wear and tear.


Semi-annually


  • Check the operation efficiency of the over speed governor.
  • Check for damage or distortions of the over speed governor and respective structural elements.
  • Check the wear of the undercut grooves of the over speed governor and the grooves of the tension pulley.


Annually

  • Check traction sheave if worn out.
  • Apply grease on the wire rope.

10.1 - ATTACHMENTS: PPM records for Elevators


SECTION 11 – The Periodic Preventive Maintenance Program for Low Current and Communication Systems

Monthly

  • Check all intercom in admission wards.
  • Check central telephone system (PABX).
  • Check page call system.
  • Check bleep/pager system.
  • Clean all panel boxes.
  • Check installed call program.
  • Check battery central box.
  • Check all devices connected to emergency plugs.

11.1 - ATTACHMENTS: PPM records for Low Current and Communication Systems


SECTION 12 – The Periodic Preventive Maintenance Schedule for Pavement and Ground

Monthly

  • Uneven ground surfaces should leveled up.
  • Ground erosion due to water or wind should be checked. Construct appropriate drainage canals in each area, as required.
  • Inspect sidewalks and pedestrian area. Inspect tile works, and replace missing or broken tiles.

Annually

  • Inspect curb stones and road markings. Paint with appropriate colors.
  • Inspect for cracks in the pavement and repair as necessary.
  • Crack repair is done if crack width is 1/4 inch or more. Narrow cracks may be surface treated.
  • Crack repair method is done either by crack sealing (for working cracks)or crack filling (for non-working cracks), either with asphalt emulsion or asphalt cement materials.

Every 3 years

  • Inspect for structurally deteriorated pavement area and patch the area as necessary.
  • Structurally deteriorated areas are determined by the crack density (spacing of the cracks) and edge deterioration (condition of the crack) present in the area. If the edge deterioration is too much, crack repairs will not suffice, and patching or area repairs are needed.

12.1 - ATTACHMENTS: PPM records for Pavement and Ground


SECTION 13 – The Periodic Preventive Maintenance Schedule for Hospital Building and Ancillaries

Monthly

  • Check that each door panel open and shut without obstruction of the door frame.
  • Check door handle and lock, and replace/repair if necessary.

Annually

  • Check each window if it opens and closes properly.
  • Check window for any cracked panels of glass, and replace the glass.
  • Inspect wall and ceiling surfaces. Cracked surfaces should be repaired and repainted. Damaged fiberboard ceilings has to replaced.
  • Inspect tiles in the bathrooms, toilets, and wash areas, and replace the missing or broken tiles.
  • Inspect tiles on the floor and wall in all rooms and hallways. Replace or repair as necessary.

Every 3 years

  • Repainting of the whole external and internal wall surfaces should be performed.

13.1 - ATTACHMENTS: PPM records for Hospital Building and Ancillaries


SECTION 14 - Sewage and solid waste handling and disposal is done in an efficient and sanitary manner, according to professional codes of practice.

14.1 Procedure:

14.1.1 SEWAGE DISPOSAL

A. Collecting Wastewater

Wastewater comes from flushing toilets, showers, baths, etc. or draining sinks and appliances. It drains into the wastewater collection system, a system of underground pipelines that collects wastewater from the hospital and throughout the community and transports it almost entirely by gravity to the municipality wastewater treatment plant.

Part of wastewater from the hospital, particularly the Pedia and OB-Gyne area, is drained into a septic tank where it undergoes a biological process called sewage treatment.

B. Sewer System

Sewers are usually pipelines that begin with connecting pipes from the hospital buildings to one or more levels of larger underground trunk mains, which transport sewage to the municipality sewage treatment facilities.

Vertical pipes, called manholes, connect the mains to the surface. The manholes are used for access to the sewer pipes for inspection and maintenance, and as a means to vent sewer gases. They also facilitate vertical and horizontal angles in otherwise straight pipelines. Sewers are generally gravity powered, though pumps may be used if necessary. The most commonly used sanitary pipe is SDR-35 (standard dimension ratio), with smaller sized laterals interconnected within a larger sized main.

Pipes conveying sewage from an individual building to a common gravity sewer line are called laterals. Branch sewers typically run under streets receiving laterals from buildings along that street and discharge by gravity into trunk sewers at manholes. Larger cities may have sewers called interceptors receiving flow from multiple trunk sewers. A lift station is a gravity sewer sump with a pump to lift accumulated sewage to a higher elevation. The pump may discharge to another gravity sewer at that location or may discharge through a pressurized force main to some distant location.

  1. Septic Tank System

A Septic Tank is an off mains drainage sewage system. Basically a large holding tank. Over time the solids (heavy particles) sink to the bottom while the liquid scum in the septic tank is discharged out into the municipality sewer system. The term 'septic tank’ refers to the anaerobic bacterial environment that exists inside a healthy septic tank.

This anaerobic bacteria which eat, live and breed in the main sludge compartment, eat away at the solids inside the septic tank and break them down.Anaerobic digestion occurs on the settled solids, reducing them. As this process takes place, the heavier particles known as solids, sink to the bottom of the septic tank over time and turn to sludge.

Most septic tanks have a baffle or chamber system built inside the tank that separates the liquid from the solid waste matter. Septic tanks can consist of one, two three or more chambers.

Excess liquid drains from the relatively clear portion of the tank into the municipality sewer system.

The entire septic system normally operates by gravity. However, in some areas where the system would be located higher than the plumbing system, a lift pump is needed.

Waste that does not decompose by anaerobic digestion eventually has to be removed from the septic tank by the Maintenance Department sewage tanker/ truck, if not, the septic tank fills up and waste water discharges directly into the surrounding area. Not only is this unhealthy and is bad for the environment, but could prove costly as well.

How often the septic tank has to be pumped out depends on the volume of the tank relative to the input of solids, the amount of indigestible solids, and the ambient temperature (as anaerobic digestion occurs more efficiently at higher temperatures).

Users of septic tank systems must be careful not to put excessive waste (e.g. through a kitchen food disposal unit) or non-biodegradable waste through their sewers. Excessive waste overloads the system design capacity, requiring them to be pumped out more frequently.

Likewise, users of septic systems should limit water usage to the maximum extent, to avoid exceeding the capacity of the tank. This will cause improper dispersing of the water portion of the waste.

  1. Maintenance and Repairs

All sewers deteriorate with age; but Infiltration/Inflow is a problem unique to sanitary sewers.
The hospital's policy on maintaining the sewage collection system in top condition, as well as residents' cooperation in not dumping grease and toxics into the system will help protect everyone's safety as well as the environment.

The Maintenance Department carries out a formal plan of preventative maintenance to stop problems before they occur. Manholes and pipelines throughout the collection system are cleaned on a regular schedule to eliminate obstruction and prevent sewage spills.

The side sewer shall never be broken or cut in order to connect a gutter or drain, or to run a plumbers snake. Tree roots, rodents, or contaminants can enter through a break, creating maintenance, health, and environmental problems.

E. Sewer Spill Prevention

SSOs - Sanitary sewer overflows (SSOs) are sewer spills. SSOs can be caused by roots, grease or other debris blocking the sewer pipe. The Maintenance Department strives to eliminate all SSOs from occurring. Hospital’s sewer pipes are cleaned and inspected on a regular basis.

F. Reporting Overflow

If sewage overflow is noticed from sewage manholes, the Maintenance Department at tel. no. 2269 should be informed immediately.


14.1.2 SOLID WASTE (GARBAGE) DISPOSAL

  1. Garbage cans/ containers are placed in all patients' beds, wards, clinics, and offices where occupants put their trash.
  2. In each shift, garbage is collected by the cleaning staff, put in the garbage bags/ bins and deliver it to the waste storage area near the side gate of the hospital.
  3. Garbage trucks regularly load the collected waste and bring it to a dump site specified by the municipality authorities.
  4. A private contractor is tasked in the disposal of hospital waste, and another one for toxic waste.

14.2 ATTACHMENTS:

· Waste Disposal Contract with a private company.

· Daily tanker truck sewage removal records.

· Sewer pipe cleaning/inspection records.


SECTION 15 - Kitchen equipment is inspected, tested and test results are documented as follows:

· Hood fans are in good operating condition, and free from grease.

· Hood filters are cleaned weekly, and no cooking done with filters missing.

· Refrigerators are connected to emergency power.

· Cold room temperature is monitored.


15.1 Procedure:

  • Hood fans should be checked regularly. Hood casing, fan blades, fan guard, and motor external must be clean and free from grime and grease.
  • Hood filters should be cleaned weekly. No cooking should be done when the filters are removed, even temporarily.
  • Fan motors should be inspected periodically. Bearings should be checked. Insulation resistance test must be done on the windings. Connecting wires must be checked for overheating and loose connections.
  • Refrigerators must be connected to emergency power. Thermostat must be checked for proper functioning or accuracy. Automatic defrosting function, if fitted, should be verified.
  • Cold room temperature must be continuously monitored and temperature readings recorded.

15.2 Attachments: (Please see Catering/ Kitchen Contractor's Documents)

  • Kitchen equipment maintenance records


SECTION 16 - Laundry equipment/ systems are inspected and tested and test results are documented.

16.1 Procedure:

16.1.1 The Periodic Preventive Maintenance for Laundry Equipments

The benefits of preventive maintenance are far too often overlooked. By creating a preventive maintenance schedule and sticking with it, the laundry department efficiency is increased, risk of injury and illness is reduced, unscheduled interruptions are minimized, and larger and more costly repairs are minimized.

The PM is done in a cycle- weekly, monthly, quarterly to yearly.While some machines like washing machines, dryers, and presses require frequent servicing, some others like dry-cleaning machine, compressor, vacuum machine and flat ironer need much less attention.

The operators must be trained to alert the maintenance staff in case of any leakages or unusual sound and also not to misuse the equipment.

DAILY

  • Washing machines should be examined for leaks daily. Besides watching for obvious puddle on the floor, someone from the maintenance staff should inspect the hoses for water and chemical leaks.
  • For dryers, operators should clean the lint screen daily. Additional steps should be taken to ensure that the equipment has unrestricted flow.

WEEKLY

  • Weekly cleaning using the blower and vacuum systems in areas covered with lint, as is the case with most laundries, can prevent big fire hazard. This also exposes the hidden cause of defects.
  • Cleaning/ greasing should be carried out on all equipments.
  • Check emergency devices to ensure that they are working properly.

MONTHLY

  • Thorough cleaning of equipments.
  • Checking the resistance of the motors, and all electrical wires.
  • Check all bolted joints.
  • Check steam pipes, valves, and sensors.
  • Check the need for pressure adjustment.

EVERY 3 MONTHS

  • Check the washer's belt condition.
  • Clean the water inlet screens.
  • Inspect anchor bolts.

EVERY 6 MONTHS

  • Vacuuming behind the tumbler every six months is recommended for dryers.


16.1.2 Safe Operation of Laundry Equipments

Proper Equipment Use Promotes Efficiency

To avoid injury while using laundry room equipment there are certain things to look for and others to avoid. The following is a list of some general operating tips:

  • Carefully read labels and instructions on all laundry equipment. Post safety instructions near each machine for easy reference.
  • Regularly run safety tests. For example, check the door interlock on washer-extractors. When testing the door interlock, attempt to start the machine with the door open, close the door and, without locking it, attempt to start the machine. If the machine starts during one of these tests, contact your service technician. Also, try opening the door during the wash cycle. The door should stay locked. If it doesn't, immediately disconnect the equipment from its power source so it cannot be operated, and contact your service technician.
  • Perform similar safety checks on tumblers. Try opening the door during the dry cycle. The machine should stop when the door is opened.
  • Pay attention to your surroundings. Never, under any circumstance, operate your washer-extractor if there is high water on the laundry room floor or if the machine is not connected to a properly grounded circuit.
  • Examine the floor for cracking. The concrete foundation should be of sufficient strength and thickness to handle the floor loads generated by the high extraction speeds. If cracking is severe, the floor needs to be reinforced with new concrete.
  • Provide sufficient space to move between pieces of equipment and for the performance of service procedure and routine preventive maintenance.
  • Use machines only for their intended purposes. For example, to reduce the risk of fire, don't put plastics, articles containing foam rubber, rags contaminated with gasoline or other inflammable solvents, or mop heads into the dryer.
  • Do not defeat machine features. Washer-extractors and tumblers are constructed with numerous safety features, such as washer door lock protection and a dryer air flow safety switch. By intentionally overriding these features, you create an unsafe condition.
  • Cut off the power when there is a problem with a machine or a jam in a flatwork finisher. Don't just turn off the machine, but turn off the power at the power source.
  • Check emergency switches and devices weekly to ensure that they are working properly.
  • Remove hot laundry from a tumbler immediately after cycle operation. Never leave a hot load sitting in a tumbler or a laundry cart unattended.
  • Throw out rags. If you have rags that have been used to clean up or apply a chemical, don't wash or dry them. For safety reasons it is best to throw them out.

16.2 Attachments:

  • PPM Records for Laundry Equipment


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