Formula Level
|
Level |
Description |
Formula |
|---|---|---|
|
MEDEQUIP |
SAMPLE - Medical Equipment Risk Assessment |
:EQUIPFUNCTN + :PHYSRISK + :MAINTREQ + :INCIDHISTORY + :OVERRIDE |
Question Level
|
Level |
Description |
Question Level |
Question |
|---|---|---|---|
|
EQUIPFUNCTN |
Equipment Function |
YES |
What is the Equipment Function of the Asset? |
Answer Level
|
Answer |
Description |
Value |
|---|---|---|
|
1THERAPEUTIC |
Therapeutic - Life Support or Life Sustaining |
10 |
|
2THERAPEUTIC |
Therapeutic - Surgical or Intensive Care |
9 |
|
3THERAPEUTIC |
Therapeutic - Physical Therapy or Treatment |
8 |
|
4DIAGNOSTIC |
Diagnostic - Surgical or ICU Monitoring |
7 |
|
5DIAGNOSTIC |
Diagnostic - Other Physiological Monitoring |
6 |
|
6ANALYTICAL |
Analytical - Laboratory |
5 |
|
7ANALYTICAL |
Analytical - Laboratory Accessories |
4 |
|
8ANALYTICAL |
Analytical - Computer and Related Equipment |
3 |
|
9MISC |
Miscellaneous - Patient Related |
2 |
|
AMISC |
Miscellaneous - Non-Patient Related |
1 |
Question Level
|
Level |
Description |
Question Level |
Question |
|---|---|---|---|
|
INCIDHISTORY |
Incident History |
YES |
What is the Incident History of the Asset? |
Answer Level
|
Answer |
Description |
Value |
|---|---|---|
|
1EXTENSIVE |
Extensive or Recent Problems |
3 |
|
2SOME |
Some or Past Problems |
2 |
|
3MINIMAL |
Minimal Problems |
1 |
|
4NONE |
No Problems |
0 |
|
5NOHIST |
No History Available or Not Applicable |
0 |
Question Level
|
Level |
Description |
Question Level |
Question |
|---|---|---|---|
|
MAINTREQ |
Maintenance Requirement |
YES |
What is the Maintenance Requirement of the Asset? |
Answer Level
|
Answer |
Description |
Value |
|---|---|---|
|
1MONTHLY |
Monthly or Less |
5 |
|
2QUARTERLY |
Quarterly |
4 |
|
3SEMIANNUALLY |
Semi-Annually |
3 |
|
4ANNUALLY |
Annually or Longer |
2 |
|
5NOTREQ |
Not Required |
1 |
Question Level
|
Level |
Description |
Question Level |
Question |
|---|---|---|---|
|
OVERRIDE |
Management Override |
YES |
Does Management want to Include Asset in Program even if score is below threshold? |
Answer Level
|
Answer |
Description |
Value |
|---|---|---|
|
1YES |
Yes, override score to Include in Program |
50 |
|
2NO |
No, do not Override score |
0 |
Question Level
|
Level |
Description |
Question Level |
Question |
|---|---|---|---|
|
PHYSRISK |
Physical Risk |
YES |
What is the Physical Risk if the Asset were to fail? |
Answer Level
|
Answer |
Description |
Value |
|---|---|---|
|
1DEATH |
Patient Death |
5 |
|
2INJURY |
Patient Injury |
4 |
|
3MISDIAG |
Misdiagnosis or Inappropriate Therapy |
3 |
|
4EQUIP |
Equipment Damage |
2 |
|
5NONE |
No Significant Identified Risks |
1 |
Score/Ranking Index
|
Minimum Value |
Maximum Value |
Risk Ranking Index |
RRI Description |
|---|---|---|---|
|
0 |
7 |
EXCLUDE |
Asset is Excluded from Program, but add ID tag as needed |
|
8 |
23 |
INCLUDE |
Asset is Included in Program |
|
24 |
100 |
OVERRIDE |
Asset is Included in Program by Management Override |