Calibrating blood pressure measuring devices

Where our calibration devices are used: Mobile calibration of blood pressure measuring devices with our software in the building services center of Solina Spiez.

Michael Sartorius (name changed) has a good feeling. His 83-year-old mother has seemed much more alert than weeks ago. Her caregivers made a good impression on him too: his desire to make things as comfortable as possible for his mother clearly goes without saying at the Solina nursing home in Spiez, Switzerland.

Efficiency and regulatory com­pliance: calibrating blood pressure monitors on site

Leaving his mother’s care to someone else was not easy for Mr. Sartorius at the beginning. But then a friend told him about Solina, the umbrella group for the leading long-term care facilities in the Bernese Highlands of Switzerland. “The physical, psychological, emotional, cultural and social needs and desires of each individual are at the heart of everything we do,” read the brochure at the time. “We aim to provide a place where people of all ages – regardless of how they have come by their limitations – can feel as much at home as possible, in an atmosphere of mutual respect and hallmarked by admiration and tolerance.” This was fortunately more than just lip service.

Scene change: the building services control center for the Solina home in Spiez, where Bruno Münger is responsible for electrical systems, electronic equipment and instrumentation. “Our technology is state of the art, of course. In Technical Services, making sure our technology provides the best possible support for people – residents and caregivers alike – is important to us. And it has to be reliable, because we’re talking about people’s health, after all. That’s something we don’t compromise.”

The Solina nursing home is located in Spiez, a picturesque town in the Bernese Highlands of Switzerland.
The Solina nursing home is located in Spiez, a picturesque town in the Bernese Highlands of Switzerland.
Essential equipment for any nursing home or hospital: professional blood pressure monitors
Essential equipment for any nursing home or hospital: professional blood pressure monitors

The same applies to blood pressure monitors, roughly 70of which are in use in the facility’s various wards. On theone hand, having instruments that are precise and reliableis critical, and the Solina staff’s experience with Bosch+ Sohn instruments has been very positive. On the other hand, however, equipment must remain precise over months and years of use. To prevent deviations, instruments are calibrated each year, a process that involves comparing measured values to highly precise control values. Instruments must pass this inspection before they can further be used.

If measurements are relevant to human health, regular instrument calibration is required by law (e.g. the Medical Devices Act in Germany and the Medical Devices Ordinance in Switzerland). The law stipulates that regular, documented testing be performed in order to maintain medical devices such as blood pressure monitors. The responsibility for risk assessment lies with the operator

False readings from blood pressure monitors are a matter of life and death, and, in the worst-case scenario, could result in physicians prescribing the wrong medication. The greatest risk, however, is of drug dosage errors, which corresponds to a risk of straining the patient’s circulatory system.

“There are no guidelines telling us how exactly to manage that risk or how to implement the Ordinance,” observes Münger. “So we came up with a process that we feel quite good about.” A folder for each blood pressure monitor was set up in the facilities management software used for managing all of the building services for the nursing home. All calibrations are documented in these folders, which satisfy the external auditor – the process solves the problems of inspection and documentation at the same time.

Münger laughs, “When we started out, we would take five blood pressure monitors out of the wards every couple of weeks throughout the year. Then we would send them to an external contractor for calibration, which meant, of course, that the instruments would be gone for a while. It was also a huge production, what with all the packing, unpacking and organizing. Plus it ended up costing almost as much as buying a new instrument.” This was why the clinic also once considered introducing a single-use policy (disposing of instruments after one year, rather than calibrating them), but the idea was quickly dismissed due to the environmental impact.

The problem of cost-efficiency had still not been addressed when Mr. Münger had an idea that was as simple as it was ingenious: from that point onward, the nursing home’s Technical Services department would perform the calibrations itself. Equipped with a battery-operated KAL 200 pressure calibrator from Halstrup-Walcher, Technical Services has since been able to calibrate monitors on site without ever having to remove them from their respective wards.

The compact, mobile calibration station with halstrup-walcher KAL 200 and Notebook
The compact, mobile calibration station with halstrup-walcher KAL 200 and Notebook

The process is simple: the mobile calibration station includes the KAL calibrator, a laptop and maintenance tools, and can be wheeled into the ward in question. Thanks to the rechargeable battery, operators do not need to fi nd a free electrical outlet before beginning their work. Technical personnel can then calibrate one blood pressure monitor after another – for the fi ve or six instruments in a ward, the process only takes about 20 minutes. Software provided by Halstrup-Walcher runs on the laptop and allows users to define a series of pressure values. In this specific example, the values entered range from 0 to 300 mmHg in increments of 50 mmHg, with the calibrator recording and holding each pressure for 10 seconds. The KAL 200 pressure generator then produces each pressure (the target value) with extreme precision and reads the actual value on the blood pressure monitor. The actual value is then entered on site in standardized test records that are administrated by the facilities management software – the data are now available at any time.

If the difference between the target and actual values is too great (the maximum acceptable deviation is 3 mmHg), the monitor in question must either be removed from the ward or sent back to the manufacturer. Because this is rarely the case, monitors can be placed back in operation immediately after calibration.

While Michael Sartorius is unaware of all of these details surrounding his mother’s care, he feels good that people are really what matters here at Solina. And he can take for granted that the technology involved is up to the task of making that happen.

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