Fact Sheet – Disposal of medical records

THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS Fact Sheet: Practice Equipment Criterion 5.2.1: Practice Equipment Our practice has access to medical equipment necessary to ensure comprehensive primary care and resuscitation.  Indicator A Equipment for comprehensive primary care and resuscitation is available within our practice (see list included below).  Indicator B Our practice has timely access to the following equipment:  Spirometer  Electrocardiograph  Indicator C Our GP(s) can list procedures commonly performed within our practice and can demonstrate that available equipment is sufficient for these procedures.  Indicator D Our practice has a schedule for the maintenance of our key clinical equipment. 1. Indicator A: What does our practice need to do? Practices need to have the necessary equipment for comprehensive primary care and resuscitation. The practice is required to have the following equipment present in the practice and in working order.  auriscope  blood glucose monitoring equipment  disposable syringes and needles  equipment for resuscitation, equipment for maintaining an airway (including airways for children and adults), equipment to assist ventilation (including bag and mask), IV access (i.e. butterflies) and emergency medicines  examination light  eye examination equipment (eg. fluorescein staining)  gloves (sterile and non-sterile)  height measurement device  measuring tape  monofilament for sensation testing  ophthalmoscope  oxygen  patella hammer  peak flow meter* or spirometer  scales  spacer for inhaler  specimen collection equipment  sphygmomanometer (with small, medium and large cuffs)  stethoscope  thermometer Last reviewed December 2006 Page 1 of 4 THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS       torch tourniquet urine testing strips vaginal speculae visual acuity charts X-ray viewing facilities *If a practice has spirometry, it is not necessary to have a peak flow meter. It is acknowledged that some practices will need to have access to additional equipment. This equipment will depend on the nature of the practice, the interest and requirements of the general practitioners (GPs), and any procedures the practice undertakes. 2. Indicator B: What does our practice need to do? The clinical judgement of the GP(s) or practice staff is used to determine the appropriate length of time for access to spirometry and ECGs. When, in the clinical judgement of the GP(s) or practice staff the patient needs access to spirometry or an ECG, how does the practice respond to this need in a manner that reflects a safe standard of care? Timely access requires that spirometry and ECGs are available for use when a patient requires these tests. For example, a patient presenting with chest pain requiring an ECG, would require the procedure within a short period of time. If a practice does not have a spirometer or ECG machine in their premises, the practice needs to be able to access this equipment within a clinically appropriate timeframe. What processes does the practice have in place to ensure ease of access to this equipment in the event of an urgent need? Examples of access to spirometers and ECG machines may include:  through an agreement with a co-located facility, e.g. pathology provider,  another service that has agreed to allow the practice to use their equipment,  by referral to a local hospital. 3. Indicator C: What does our practice need to do? The practice needs to know that they have sufficient equipment for procedures commonly performed within the practice. The nature of the practice (i.e. special interests of the GP[s]) will assist in identifying the kinds of equipment required by the practice. For example, practices with high numbers of paediatric patients will require child size equipment, and practices that perform a large amount of skin cancer detection will require dermatoscopes and lesion excision equipment. Inventory and audit of usage (e.g. via audit of patient health records) can be used to determine the level of need for equipment and supplies and if the equipment available is sufficient to meet the practice’s demand. This concept is also raised in Criterion 5.3 Indicator B: Our GPs and staff with designated responsibility can describe in detail how the use of sterile equipment is assured, including where relevant:  Provision of an adequate range of disposable equipment. Last reviewed December 2006 Page 2 of 4 THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS 4. Indicator D: What does our practice need to do? Recent research highlights that some equipment may be inadequately maintained leading to inaccurate results. For example, inadequately maintained scales lead to inaccurate weight readings. 1 General practice equipment needs to be maintained correctly in order to be effective when there is a clinical need. Attention needs to be given to the care, storage, cleaning, checking, maintenance and calibration of equipment used. Equipment that requires calibration or that is electrically or battery operated, e.g. ECG machines, spirometers, autoclaves, vaccine refrigerator, scales, defibrillators, needs to be serviced on a regular basis (i.e. in accordance with manufacturers requirements) to ensure that it is maintained and in good working order. It is also good practice to ensure that electrical equipment is tested and tagged annually to ensure the equipment is safe to use. 4.1 How to schedule maintenance An up to date schedule of maintenance will assist in ensuring equipment is in working order. Some practices have shared how they manage the scheduling of maintenance:  it may be useful for the practice to appoint a person to be responsible to ensure that all servicing requirements are carried out.  it may be helpful to develop a checklist, detailing the schedule. When developing a checklist, it may be helpful to start by listing:  all equipment used by the practice that requires servicing or maintenance  list the service interval, e.g. daily, weekly, monthly, quarterly and annually  person responsible for servicing (e.g. steriliser technician)  date the servicing is due  date performed  who performed the service (e.g. reception staff change battery in vaccine refrigerator thermometer) Some practices set up a reminder system for maintenance using their practice software. An example of this is by using the appointment system to set up an appointment for drug fridge defrosting and cleaning. Some practices use their medical software, by setting up a ‘dummy’ patient file and using the recall function to flag maintenance requirements. An example of a suggested checklist is included below. Not every practice will have every piece of equipment, and practices may need to schedule different service intervals depending on their equipment servicing requirements. 1 Gerner B, McCallum, Sheehan J, Wake M. Are general practitioners equipped to detect child overweight/obesity? Survey and audit. Journal of Paediatrics and Child Health 2006: 206-211. Last reviewed December 2006 Page 3 of 4 THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS Fact Sheet: Practice Equipment EXAMPLE EQUIPMENT SERVICING SCHEDULE Type of servicing Person Date required responsible service is due Check oxygen levels and connections Clean chamber, check outlet and seals Check batteries and light globes Change water Check expiry dates Hi Lo calibration Change battery Defrost and clean Electrical test and tag Refrigerator temperature audit Practice nurse/staff Practice nurse/staff Practice nurse/staff/GP Practice nurse/staff Practice nurse or GP Practice nurse/staff Practice nurse/staff Practice nurse/staff Electrician Division staff Service interval Equipment Date performed Who performed service Daily (when the practice is open) Oxygen gauges and fittings Steriliser Auriscope, ophthalmoscope Steriliser Emergency drugs Glucometer See steriliser logbook Weekly See steriliser logbook Monthly Quarterly Refrigerator temperature monitor Vaccine refrigerator ECG machine Refrigerator temperature monitor Annually Last reviewed December 2006 Page 4 of 4