Malfunctions and Management of Home Medical Equipment in Visiting Nursing Stations and Collaboration with Clinical Engineers

Shuichi Hamasaka,1,2 Kaoru Kyota,3 Satoko Mizohata,3 Keiko Tsukasaki3 1Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan; 2Department of Clinical Engineering, National Hospital Organization Iou National Hospital, Kanazawa, Ishikawa, Japan; 3Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, JapanCorrespondence: Shuichi Hamasaka, Department of Clinical Engineering, National Hospital Organization Iou National Hospital, Ni73-1, Iwade-machi, Kanazawa, Ishikawa, Japan, Email hamasaka.shuichi.wj@mail.hosp.go.jpBackground: Home medical equipment is extensively utilized in Japan; however, its management is typically overseen by visiting nurses or medical equipment manufacturers rather than by clinical engineers (CEs), who are specialized professionals. Visiting nurses often lack expertise in medical equipment, and manufacturers face legal limitations regarding equipment management. Improper operation or maintenance threatens patient safety. This study aims to elucidate the relationship between equipment malfunctions and management practices at visiting nursing stations (stations), as well as to assess the perceived need for CEs.Methods: A nationwide cross-sectional questionnaire survey was conducted, in which a stratified random sample of 500 stations was selected nationwide by region, with 76 stations providing valid responses. A questionnaire survey was conducted to assess the incidence and management of malfunctions across six types of medical equipment: infusion pumps, syringe pumps, electric suction units, oxygen concentrators, non-invasive positive pressure ventilation devices, and tracheostomy positive pressure ventilation devices. The survey also evaluated the perceived necessity for CEs. Associations between equipment malfunctions and management practices were analyzed using the chi-square or Fisher’s exact tests.Results: Among the 76 stations, device abnormalities were the most frequently reported cause of malfunctions across all six equipment types, accounting for over half of the cases. In more than half of the incidents, responses were managed by visiting nurses and manufacturers. Significant associations were identified between infusion pump malfunctions and hospital affiliation, as well as between syringe pump malfunctions and the presence of operation manuals and safety information collection. Notably, 81.6% of stations recognized the need for CEs in home medical care.Conclusion: This study elucidated the relationship between equipment malfunctions, management practices at stations, and the perceived need for CEs. Our findings highlight the importance of establishing a collaborative framework between stations and CEs.Keywords: home medical care, medical device, risk management, maintenance, device malfunction, patient safety