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Centro Unv*rsitário Santo Agostinho
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www*.fsanet.com.*r/revista
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Rev. FSA, Tere*i*a, *. *9, n. 8, art. 12, p. 252-266, *g*. 20*2
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ISSN Impresso: *806-6356 I*SN Ele*rônico: 2317-2983
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http://dx.doi.org/10.12819/20*2.19.8.12
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*aintenance Management in Hospi*a* Equipmen*: Sy*temat** Review
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Gestão ** Manutenção *m Equipamen*os Ho*p*talares: R*visão Sistem**ica
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A*a Luiza Fe*rei*a Mame*e
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*estrad* em Engenharia de Pro*uç*o pela Universi***e Federal *e Catalão
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Gradu*ção em Eng*nharia de Pr*dução pela Unive*si*ade Federal de G*iás
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E-mail: *na*uizafma**de@gmai*.co*
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André Alves *e **sende
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Do*tor em Engenhari* M*cânica
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Pr*fessor na Un*versidade Federa* de C*talão
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E-mail: a*res*nd*@gmai*.com
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Ender*ço: *n* Luiza Fer*eir* Mamede
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Editor-*hefe: Dr. Tonny Kerley de Alencar
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*v. Dr. Lamartine P*n*o *e *ve*ar, 11*0. Se**r
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Rodrigues
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Univ*r*itár*o - CEP: 75704-*20. Catal**-G*, Brasil.
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Endereço: André A*ves de *e*ende
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Arti** r*ceb*do em 26/0*/2022. Últim*
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*ersão
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Av. *r. Lamar*ine Pinto *e Ave*ar,
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1120. Se*or
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receb*da em 1*/05/2022. Ap**vado em 18/*5/2022.
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Univers*tár*o - *EP: 75704-020. Catalão-*O, *rasil.
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A*aliado **lo sis*ema Triple Review: Des* Revie* *)
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pelo Editor-Chefe; e b) Doub*e Blind R*view
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(avaliação cega por d*is ava*i*dores da á*ea).
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Revisã*: Gra*a*ica*, Normativa e d* Formatação
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Maintena*ce Manage*ent *n *ospit*l Equipment: Systema*ic Review
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2*3
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A**TRACT
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T*e main*enanc* o* hosp*tal equipment is o* fun*amental import*nce for an adequa*e **di*al
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diagno*is. The condu*t
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of *his mainten*nce can be m*naged in different strategi*s. T*e
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p*rpose of this study is to syst*matic*lly *eview the main types of mai*tenance
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us*d
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by
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*ealthcar* organizations to manage hosp*tal equip**nt
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between the period 2010 and *0**.
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Fo* this, a li**rat*re *e**ew was car*ied ou* in the el*ctronic
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dat*b*ses Pub*ed and Capes
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Journals Por*a*/M*C. The predom*nance of the app*i**t*o* *f preventive *aintenance in the
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*os*ital *ector wa* highligh*ed, howe*er other methodologies such as predic**ve maintenance,
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*vidence-based and reliab*l*ty cente*ed mainte*a*c* (RCM) were proposed as a way to ob*ain
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effi*i*nt results and mitig*te the r*s* of failures. It has been pr*pos*d
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that the u*e o*
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mathemati*al approac*es shou*d *e f**the* e*p**red in
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t*is a*e*. *her*for*, i*crea*es in
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* he
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overall *f**ctiven*ss of h*spital **u*pment are e*pected.
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Keywords: Mainten*nce
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Strategies.
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Preventive
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Mainte*ance.
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Overall
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Equipment
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Eff*ctiveness.
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RESUMO
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A manutenção do* equip*mentos
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hospitalares * de fundam*nta* impor*â*cia p*ra
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um
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diagnóstico médi** ade*uado. A cond*ção desta man*tenção pode ser gerenciada em
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diferen**s estratégias. O ob*etivo deste estudo r*visar *istematicamente *s principais tipos é
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de manute*ção uti*iza*os pelas organizações *e saúde *ara
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gerenc*ar
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equipam*ntos
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*ospi*alare* entre o período de 2010 * 2020. Para isso, foi r*al*zada uma revi*ão de literatura
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nas
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*ases de dado* eletrônicas P*bMed e Portal d* Periódicos Capes/M**. Destacou-se a
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*redominânci*
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da aplicação da manut*n*ão pre*e*tiva no setor hospita*ar, porém o*tras
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metodologia* com* m**utenção predit*va, man*tenção ba*eada em *vidências e manutençã*
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ce*t*ada *a confiab*lidade (RCM) foram *ro*osta* como forma d* ob*er re*ultados *fi*ientes
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e mitiga* *s riscos ** falhas. Foi pro*o*to que o uso *e ab*rd**ens matemáticas *e*e ser mais
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explorado nest* área. Portan*o, são esperad*s aument*s na
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eficác*a g*ral *os equ*pamentos
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hos*itala*es.
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Palavras-chave: E*trat*gi*s de *anutenção. M*nutenç*o Pre*e*tiva. Eficác*a *er*l
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*o
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Equ*pamento.
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R*v. FSA, Tere*ina PI, v. *9, n. 8, art. 12, *. 252-266, ago. 2022
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www4.fs*net.com.br/r*vista
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A. L. *. Mamede, A. A. Resende
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254
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1 **TRODUCTION
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*edical e*uipment plays a crucial role in the p*ovision of *ealth **rv*ces, so they are
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*ncreas***ly cri*ical to t*e provision of eff*cien* s*rvices. *h* ab*enc* or fa*l*re of medical
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equipment can sign*ficantly affe** the sector and ha*m people's li*es, s* it is n**e*sary to
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mai*tain stri*t standards and *eq*irements to ensure the saf*ty o* patien*s and staff. A*
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a
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result,
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it ** extrem*ly impor*ant to *aintain a maintenance program *o ensu** that the
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equ*pment *s
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** *t* b*st co*d*tion, t* avoid failu*es a*d
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b**akdowns du*ing operation
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(Waeyenbergh and *in*el*n, 2002).
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In health organizatio*s, the larges* investment is usuall* i* me*ica* equipment,
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*ec*nd o*l* *o the real esta*e *ector (land and build*ngs). Thus, in addition *o b*i*g essen*ial
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*o provide **fe *n* effective *a*e, it also has an imp*ct o* *** *ncome o* health organizations.
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*n view of this, the maintenance and mana**ment
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of med**a* equipm*nt requi*es *are*u*
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*uperv*s*on from **alth admin*strators (Wang, 2012).
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Th* medical fi**d a*o*ds a*ting with the poss*bility of "*rial *nd error" and **ilures in
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th* services pr*vided to pa*ien*s, a* a*y m*stake can repre**n* a risk to the li*e ** a human
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*eing (*erb*no and T*rra, 2**0). *here is now * *ide va**ety of medical equip*ent and *he
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*riticali*y of its reliabi*ity may var* according t* i*s a*pli*ation.
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Dh*llon (*011) categori**s ** follow*: "category I" includ*s devi*es t*at are dire*tly
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an* i*me**atel* responsible for the p*tie*t's
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life, such as *e*pir*tors, **rdiac defi*rilla**rs;
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"Ca**gory II" i*c*ud*s *evices used for rout*ne diagnostics, a **i*ure i* th*s eq*ip*ent is not
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as *ri*ic*l as in *hos* ** categor* I, as in this *ase *here is time for
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repair; "Category III"
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includes e*uipm*nt not essential to the patie*t's life or well-being, s*ch as electric
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beds,
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wh*elchair*.
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According to OMS (O*ga**zación *u*dial d* la Salu* [OMS], 2012), *ai*t*n*nce
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c*n be divi*ed i*t* two m*in categories:
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In*pection and Pr*vent**e Mai**e*anc* (*MP): All e*s*ntial p*ogrammed activi*ie* to
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e*su*e tha* me*ical equipment (EM) are functioni*g pr**e*ly and are well m*i*tained.
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Pr**entive maintena*ce (MP): All act*vities perform** to exte*d t*e *ife o* a devic*
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an* p*event d*mage (such as: calib*ation, c**aning, l**rica*ion, replac*m*nt of par*s,
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etc.); Inspe*tion: All s*he*uled acti*ities es*enti*l *o *nsure th*t the equip*ent i*
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functioning properly. It incl*des operati*na*
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and *afe*y inspect*ons. Th*y are
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*erformed in conjunction with PM, co*r*ctive mainte*ance or calibrat*on, but **n als*
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be performed in*epe*dentl*, *s scheduled activ*ty a* define* *ntervals.
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Re*. FSA, Teresi*a, v. 19, n.8, art. 12, p. *5*-266, ago. 2022 *ww4.*s**et.com.br/*evista
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Maintenan*e Manageme*t in H*sp*tal *quipment: Sys*ema**c Re*iew
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255
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Correct*ve main*enan*e (MC): Pr*c**s to restore the integrity, safety or operat*on of
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equi*ment aft*r a fa*lure. MC an* u*sch*duled mai*tenanc* ar* cons**ere* synonyms
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fo* repa*r.
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S**temat*c *eviews of *he *iterature that assess the criticality of equ**m*nt and
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ana*y*e the *aintenance strate*ies applied i* the c*n*ext **
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h*alth care, publi**ed *etween
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20** a*d 2*1*, point ou* add*t*ona* gaps *nd resea*ch nee*s. Authors pointed out *hat few in-
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dept* studies *ave been carr*ed out to e*aluate t*e effic**ncy and effecti*ene*s of the
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mai*tenance strateg*es
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commonly *mplem**ted
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and present a raised debate about the
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credibility
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o* *he re*omm*nda*ions made by the manufacture*s. Fina*ly, they point out that
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there is evide*ce i* th*
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lit*rat*re that i*dicates
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that mat**mati*** modeli*g is signific**tl*
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more flexib*e than empir*cal approaches, *herefore,
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it wou*d be benefi*ial
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f*r medical
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main*enance to *xpl*re this bias (*ahfoud, El B*rkany and El Biy*ali, 2016).
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*not*er study based on a bi*liogra*hi* *ev*ew on op*im*zation of mai*ten*nce based
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on reliab**ity in healthcare
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or*an*zations
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from 2000 to 201*, found *everal m*de*s of
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uncertain*y i* prioritizing medical equipmen*. The st*dy h*g*ligh** that t*i* is *he heart of
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m**ical equipment manag*me*t programs, with risk b*i*g one of the most relev**t *r*teria in
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m**t prio*itization pro*le*s. In sequ*nce, the fun*tion *f the equipment, the need for
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maintenance and the rate of *se *ppea*. Howev*r,
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*he study *oi*ted out that exper*mental
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**proaches for dat* c*llect*on and treatm*nt are lack*ng in o*der to ob*ain reliable quan*ita*i*e
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r*sults (Mahfo*d, *bdellah *nd El Biyaali, 2018).
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It i* essential, therefore, th*t h*alt* in*titutions, *egardles* of si*e, employ an
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appropria*e ma*ntenance program f*r m*dical equ*pm*nt, which will vary accordi*g to th*
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complexity of each location. Thus, t*e present syst*m*ti* review aims to
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an*ly*e how
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Journals Portal/MEC from *a* to J*ly
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2020 *n or*er to *ystemat*cally in*e*tigate original
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</page><line>
studies that ev*lu*t*d th* maintenance of *ospital equi*me*t.
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*or *his *urp**e, k*ywords we*e co*tinually referred *o in studies in the area a** the searc*
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was carried ou* usi** *he follo*in* terms: maintenance *anagem*nt in hospi*al e*uip*en*
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Rev. FSA, *eres*na PI, v. 19, n. 8, art. 12, p. *52-266, ago. 2022 www4.f*anet.co*.br/rev*sta
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</par><page>
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A. L. F. Mamede, A. A. Rese*de
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256
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</par><par>
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AND maintenance and en*ineering, *ospital AND maint*nance manage*ent *n me*ica*
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equipment. ** additional fi*tering, only peer-review*d articles **re s*lected, i* English
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an*
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da*ed betw*en 2010 *nd 2020, and after sel*cting the studi*s, thro*g* * co*ple*e rea**ng and
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analyzing *he e**gibility criteria, only works publis*ed in the last 10 yea*s remained.
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T*e followin* eligibility *r*teria wer* sele**ed to s*l*ct the *rticles: I - be an original
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*r*i***; *I - dea* with maintenance o* hospit*l e*uipment; III - deal wi*h hos*i*al maintenance
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manageme*t m*thods. St*di** wer* excluded that had: I - focu* on fo*m* of administration; II
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- *ocus o* crea*ing compute*i*ed **stem*;
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III - *ocus on costs; IV - study on the equipment
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re*ords wer* id*ntified in
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the two da*abases. After the first se*ect**n by reading
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*itl*s
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and
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</par><par>
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*bs*r*c*s, 3.9*9 *rticles were *onsidered ou* *f scop*, all ** which were r*moved. Of t*e 40
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articles le*t to be r*ad in f*ll, a total of 12 articles met *h* *ligibili*y crit*ria and w*re in*l*ded
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</par><par>
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in the qualitative summa*y. T***e was no
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additional s*arch for papers thro*g* the list *f
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</par><par>
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refer*nces o* t** se*ected ar*icles. T*e complete fl*wcha** *f the se*ection procedure i* shown
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in *igure 1.
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</par><par>
</page><line>
Fig. 1 - Flo*chart *f **e selection proc*ss for *h* articles inclu*ed in th* systemat*c
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review.
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Rev. FSA, Te*esina, v. 19, n.8, art. 12, p. 252-266, a*o. 2022 www4.fsanet.com.br/rev*sta
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</par><page>
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Maintenanc* Manage*ent in H*spi*al Equipment: S*stem*t*c Review
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*57
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</par><par>
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a. Characteristics *n* Method*logi*al *uality of Includ*d Studies
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The chara*teris*ics and m*th*dological quality des*ribe the *ubli*a*ions inc*uded i*
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thi* review. All articles in*l*de* in this re*iew w*re pub*ished in the last ten year*, wi*h 67%
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</par><par>
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(eight) (Kh*l*f et a*., 2015; Se*di, *016; *ala et
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al., 2018; Iadan*a et al., 2019; Pongra* et
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</par><par>
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al., 2019; Sali*, Mazlan and Salim, *019; Shamayleh, *w*d and Abdulla, 20*9; Shamayleh,
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</par><par>
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*wad *nd Farhat, 2*20)
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pu**ished between 2015 and 20*0. Of these, 5*% (seven) **re
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</page><line>
co*ducted in deve*oped countrie* and 42% (five) in developing countri*s.
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Only one artic*e was conducted using only questionnaires (Al**han* *t al., 2013) as
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an instrume*t f** obta*ning information, one was through interviews (Salim, Mazlan and
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Salim, *01*), t*ree *erformed equi*m*nt data co*lec*ion on site (Vala et al., 2018; Iadanza *t
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al., 2019; Salim, Mazlan and Sali*, 2019; S*a*a*leh, Awad an* Ab*ulla, 2019), four used
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*n existing d**abase (re*o*d / maintena*ce hi**ory) (Hamdi et al., 2012; M*n*ati, Dori and
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Gentili, 2012; *hal*f et al., 2013; Shamayleh, Awad *nd Fa*hat, 202*), anothe* three did not
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inform how (Khalaf et al., 2015; Sezdi, 2016; Pongrac et al., 2019).
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*f the selected work*, five (42%) (*am*i et al., *0**; Kh*laf *t al., 2013, 2015;
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Pongrac et al., 2019; Sa*im, Ma*lan and Sal*m, 20*9) d*d *ot specify the type of instit*tio*
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R*v. F*A, Ter**in* PI, v. 19, n. 8, art. 1*, p. 252-**6, ago. 20*2 www4.fs*ne*.com.br/*evista
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</par><page>
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<line>
A. L. F. Mamede, A. A. Re*e**e
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258
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analyzed,
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an*the* five (42%) (Min*ati, Dori
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and Gentili, 2012; *li*ha*i et al., 2013; Sezdi,
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</par><par>
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2016; V*la et al., 20*8; Iadanza e* al., 2019) analyzed teaching hosp*tal u*its (un*ver*ity
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students), **e (8%) (Shama*leh, *wad and Farhat, *020) in a public i*stitution an* one in a
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*rivate i**titution (*hamayleh, Awad and Ab*ulla, *01*). R*gard*ng *he type of mainten*nce
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</par><par>
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app**ed or *ncoura**d
</line>
<line>
by
</line>
<line>
each job, mos* st*die* (58%) *ere a*out *rev*ntive
</line>
<line>
mai*ten*nce
</line>
</par><par>
<line>
(Hamdi et al., *012; *iniati, Dori an* Ge*tili, 2012; Alikh*ni et al., 20*3; Khalaf et al., *0*3,
</line>
<line>
2015; Vala et a*., 2018; Pongrac et al., 2*19). Cor*ective mainten*nce was mentioned, bu* *t
</line>
<line>
was no* used **one and as t*e mai* in a*y work. *eliabilit*-cen*ere* maintenance (RCM) was
</line>
<line>
*p*lie* to t** jobs (*al*m, Ma*lan and Sal*m, 20*9; Sham**leh, Aw*d and Abdull*, 2019),
</line>
<line>
p*edic*i** maintenance als* ** two (S*zdi, 2016; S**mayleh, Awa* and Farhat, 2020), whi*h
</line>
<line>
is eq*iv*l*nt to 17% *a**. Finally, e*idence-ba*ed mainten*nce was cited in an article (8%)
</line>
<line>
(I*danza *t al., 2019). T** preva*en*e of maintenance to*ls th*t see* to prevent th* eq*ipment
</line>
</par><par>
<line>
from reach*ng the
</line>
<line>
point of fai**re was found, this is *ue to the *isk th*t failure* in medical
</line>
</par><par>
<line>
equi*ment represent ** the patient an* the o*e**tor, *o *t **oul* be d*** as much as possib*e
</line>
<line>
so that they do not happ**. Table 1 summari*es this infor*ation.
</line>
<line>
Tab*e 1 - Desc*iption of st*dies included in the revi*w. (n = 12)
</line>
</par><par>
<line>
Study ch**acteristics
</line>
<line>
N
</line>
<line>
%
</line>
</par><par>
<line>
Place of *erformance
</line>
</par><par>
<line>
Developed co*ntr**s
</line>
<line>
7
</line>
<line>
58%
</line>
</par><par>
<line>
De*eloping countries
</line>
<line>
5
</line>
<line>
*2%
</line>
</par><par>
<line>
Year of publication
</line>
</par><par>
<line>
20*0-2015
</line>
<line>
4
</line>
<line>
33%
</line>
</par><par>
<line>
2015-2*20
</line>
<line>
8
</line>
<line>
*7%
</line>
<line>
Data c*llection form
</line>
</par><par>
<line>
I*t**views
</line>
<line>
1
</line>
<line>
8%
</line>
</par><par>
<line>
Que*tionnaires
</line>
<line>
1
</line>
<line>
8%
</line>
</par><par>
<line>
Mainte*ance records / history
</line>
<line>
4
</line>
<line>
33%
</line>
</par><par>
<line>
On-site data collection
</line>
<line>
*
</line>
<line>
2*%
</line>
</par><par>
<line>
Other or not inf*rmed
</line>
<line>
3
</line>
<line>
25%
</line>
</par><par>
<line>
Type ** h*al*h ser**ce
</line>
</par><par>
<line>
Public Institutio*
</line>
<line>
1
</line>
<line>
8%
</line>
</par><par>
<line>
*rivate Institution
</line>
<line>
1
</line>
<line>
8%
</line>
</par><par>
<line>
Uni*ersi*ary hospita*
</line>
<line>
5
</line>
<line>
42%
</line>
</par><par>
<line>
Oth*r*
</line>
<line>
5
</line>
<line>
42%
</line>
</par><par>
<line>
Type of maintenance appli*d
</line>
</par><par>
<line>
P*eventive mai*te*a*ce (PM)
</line>
<line>
7
</line>
<line>
58%
</line>
</par><par>
<line>
C*rrective mai**enanc* (*M)
</line>
<line>
*
</line>
<line>
0%
</line>
</par><par>
<line>
Reliabilit*-centric maintenance (RCM)
</line>
<line>
*
</line>
<line>
1*%
</line>
</par><par>
<line>
Evi*ence-b**ed maintenance
</line>
<line>
1
</line>
<line>
8%
</line>
</par><par>
<line>
Predictive M*int*nance
</line>
<line>
*
</line>
<line>
17%
</line>
</par><par>
<line>
Ta*le 2 hi**l*ghts which
</line>
<line>
equipment was analyzed eac* s*udy, which *ailur* i*
</line>
<line>
was
</line>
</par><par>
</page><line>
obse*v*d and what *ype of maint*nance was *pplied or *ndicated for each one. *ome ****cted
</line>
<line>
Rev. *SA, Teresina, v. *9, n.8, *rt. *2, p. 252-266, ago. 2022 www*.fsane*.*om.br/revista
</line>
</par><page>
<par>
<line>
Maintenance Ma*agement in Hospital Equi**ent: Sys*ematic **v*e*
</line>
<line>
259
</line>
</par><par>
<line>
works did *ot make t*e indi*a*io*s *f equipm**t or failure, eve* so *hey were *onsidered
</line>
<line>
eligible for fulf*lli*g othe* c*it*ria.
</line>
<line>
Table 2 - List o* e*uipment st*died, found fa**ts of ty*e of appl*** maintenance.
</line>
</par><par>
</par>
<par>
</par>
<par>
</par>
<par>
<line>
fl**d; and oth*rs.
</line>
<line>
Table e*ror, brake failure,
</line>
</par><par>
<line>
Vala et al.
</line>
<line>
Radiotherapy; renal therapy
</line>
<line>
c*llimator err**, syst*m error,
</line>
<line>
Preven*ive
</line>
</par><par>
<line>
(2018)
</line>
<line>
unit; pulmonary ventilat*rs.
</line>
<line>
pri**er error, co*pres*or err**,
</line>
<line>
main*enance
</line>
<line>
gantry tran*ducer error, a*d others.
</line>
</par><par>
</page><line>
The study of Hamdi et a*. (**12) introduc** a smart work order priorit*z*tion s*stem.
</line>
<line>
Alt*ou*h it is about creating a s*stem, the authors pay special atte*tion to th* way o*
</line>
<line>
*rioritizing eq*ipment and the need for preventi*e maintena*ce. They state that a *ailure of
</line>
<line>
Rev. FS*, Te**sina PI, v. 19, n. 8, a*t. 12, p. 252-266, ago. 2022 w*w4.fsa*et.co*.br/rev*sta
</line>
</par><page>
<par>
<line>
A. L. F. Mamede, A. A. Resend*
</line>
<line>
2*0
</line>
</par><par>
<line>
medical equipment i* an extremely sensitive issue, *in*e each devic* is dire*tly and closely
</line>
<line>
rela*ed ** the healt* an* well-being *f pati*nts, but that a properly wei*h*ed *reven*iv*
</line>
<line>
maintenanc* strategy is neces**ry f*r *he equipme*t to *perate in a s*fe and economical.
</line>
<line>
Ano*her *tudy highlig*ts the *m*ortance of maintenan*e to *itigate the clinical risk
</line>
<line>
cau*ed by *dv*rse even*s in healthc*re. It aims to de*el*p a s*stem that h*lp* d*cisi*n makers
</line>
<line>
to plan preventive m*in*ena*ce an* s*fety co*trols, defin*ng new tec*nical in*i*ators with *
</line>
<line>
*imple databas*. For this, it highlig*ts the impo*tan** of defining maintenance *riority **dex
</line>
</par><par>
<line>
takin* i*to *ccount *h* fun*tional importa*ce of
</line>
<line>
the device (criticality), the type o*
</line>
</par><par>
<line>
tec*nology and the tendenc* ** com*lexi*y and failure (Mi*i*ti, *ori and Gentili, 2012).
</line>
</par><par>
<line>
The other studies cited a
</line>
<line>
*e*y wide variety of equipment *hat ranged f*om ol*er
</line>
</par><par>
<line>
t*chnologies, such as a puls* oxime*er to *igh tech*ologi*s, such as co*put**
</line>
<line>
tomo*raphy(S*z*i, 2*1*). The fa*lure* were *lso diverse, with some s**dies c*t*ng the specif*c
</line>
<line>
failur*, such as "batt*ry failure" (*adanza et al., 2019), "Luminome*er volt*ge o*t of rang*"
</line>
<line>
(Shama*le*, Awad and F*rhat, 2020), other* classified it as "type* of ma*ntenan*e services,
</line>
</par><par>
<line>
envi*onmental or human factor*" (Vala et **., 2018). *ome *orks
</line>
<line>
did not focu*
</line>
<line>
*n
</line>
<line>
t he
</line>
</par><par>
<line>
description of the flaws (M*niati, *o*i and Gentili, 2012; Khala* *t al.,
</line>
<line>
2015; Iada*za et al.,
</line>
</par><par>
<line>
2019; Shamayleh, Awad and Farhat, 2020).
</line>
</par><par>
<line>
* DISCUSSIO**
</line>
</par><par>
<line>
The review car*ie* *ut during the res*arch showed th* p*ed*mi**nc* of th*
</line>
<line>
app*ica*ion of p*even**ve mainte*a*ce *n medical equi*me*t. Th* studies pres*nted ways to
</line>
<line>
develop an ad*quate and ef*icien* maintenanc* i* order t* mitigate the clin*c*l risks caused by
</line>
<line>
adv*r*e event* in the hea*th area.
</line>
<line>
(Al*khan* *t al., *01*) per*o**ed a descriptive a*alysis based on in*ormation fro*
</line>
<line>
the yea* 2009 from a **dical center located in Ir*n. The *esea*ch was *arri*d out considering
</line>
</par><par>
<line>
o*l* neurologica* *evices tha* we*e classified *nto *o*r ca**gorie* according
</line>
<line>
to
</line>
<line>
their
</line>
</par><par>
<line>
specificiti*s. Based on his*orica*
</line>
<line>
d*t* and categories, *he a**ho*s established the
</line>
<line>
ideal
</line>
</par><par>
<line>
prevent*ve maintenance p*riods for each p**ce of e*uipment.
</line>
<line>
For *om*, such as magnet*c
</line>
</par><par>
<line>
res*nance i*age (MRI), each part *f t*e device requi*es di**ere*t contro* periods, r*ngin*
</line>
<line>
*rom * to 24 months. Thu*, the authors sh** that the im*lementation of a preventive
</line>
<line>
m*inten*nc* syst*m is crucia* for *he institut*ons, as it pre*ents problems, red*ces cost* and
</line>
<line>
op*im**es uptime
</line>
</par><par>
</page><line>
Rev. FSA, *er**ina, v. *9, n.8, art. 12, p. 252-**6, ago. 2022
</line>
<line>
www*.fsanet.com.br/revista
</line>
</par><page>
<par>
<line>
*ainte*ance Man*gement in Ho*pital Equ*pment: Sys*ematic Revi*w
</line>
<line>
261
</line>
</par><par>
<line>
*ec*sion *upport *yst**s an* s*ft*are have b*en p*oposed which, *hrough pre-
</line>
</par><par>
<line>
established indexes and crit*ria,
</line>
<line>
a*sist in maintenance manageme*t, pr***itization of *ork
</line>
</par><par>
<line>
orders, among other features. Such studies were included *n the presen* revi*w bec*u*e t*ey
</line>
</par><par>
<line>
present
</line>
<line>
det*iled data o* the pr**entiv* maint*nanc* analyzed. The indices used *ake i*to
</line>
</par><par>
<line>
accou** the area
</line>
<line>
of
</line>
<line>
activity a*d lev*l of comple*it* of the equipment (Mini*ti, Dori
</line>
<line>
and
</line>
</par><par>
<line>
Ge*til*, 2012), *unction, place of u*e, *ospital load, time sin*e req*est, presenc* of an
</line>
</par><par>
<line>
alterna**ve and distance from the ne**est *ospital co*tai*ing the s*me
</line>
<line>
device (H*mdi et al.,
</line>
</par><par>
<line>
2012). B*t* system* ha*e proven their *ffe*ti*e*es* for managi*g prevent*ve *ain*enanc*.
</line>
<line>
Th* n*ed to implement maintenance strateg*es **at m*x*mize equipment a*ailabili*y
</line>
<line>
led th* authors Vala et al. (2018) to use a risk-based app*oach. Through well-s*ructured steps
</line>
<line>
an* the use of t*o*s su*h *s Pareto analys**, "5-Wh*" an* FME*, from which fa*lur* modes
</line>
<line>
a** compon**t *ailures are analyzed and classified, in addition to i**ntifying t*e roo* causes
</line>
<line>
*f failure mode*, it was pos*ib*e to **velop op*ration a** maintenance protocols for c*itical
</line>
</par><par>
<line>
devices.
</line>
<line>
Th* protocol proposed b* the *u*hors was
</line>
<line>
*ivided into three parts that s**u*d be
</line>
</par><par>
<line>
pe*form** by biomed*cal e*gineers, being w***ly *asks, mo*th*y task*
</line>
<line>
and, finally,
</line>
</par><par>
<line>
pe*form**g preven*ive maintenan*e ev**y 3 m*n*hs, w*ich before the study was done ever* 6
</line>
</par><par>
<line>
m o*t h* .
</line>
<line>
Th*s study **o**s *he importance of *ata collection a*d ***l*s*s, as wel* as the
</line>
</par><par>
<line>
d*finition of mainte*ance protoco*s t* mitigate frequent failures and *ncrease the availab*lity
</line>
<line>
of equipme*t.
</line>
<line>
*n h*s work, Sezdi (2*16), explored two di*ferent main*enanc* strategi**, separating
</line>
<line>
th* d*vice* bet*een those o* *l* technology *o be manage* wit* p*ev*ntive mai**enance *nd
</line>
</par><par>
<line>
those *f h*gh
</line>
<line>
technolog* that wou*d re*eiv* predict*ve maintenance (PdM). The pr*ventive
</line>
</par><par>
<line>
ma*ntenance was *hr*ugh per*ormance verif*catio* and sa*et* te*ts wit* interva** that var*ed
</line>
</par><par>
<line>
from 6 to
</line>
<line>
1* m ont hs .
</line>
<line>
The predictive, h*we*er, was th*ough s*hedul*s an* daily che*ks,
</line>
</par><par>
<line>
e*suring tha* the *mall*s* fai*u** wa* repo*t**. Tra*nings wer* *ro*ided, provided by the
</line>
</par><par>
<line>
*a*ufactur**, to use*s who w**ld carry
</line>
<line>
out
</line>
<line>
daily ch*cks, as the s*udy consid*red
</line>
<line>
that the
</line>
</par><par>
<line>
lev*l of **owledge could affect
</line>
<line>
the standards *f r**iability and fa*lure. T*e author *tressed
</line>
</par><par>
<line>
tha*
</line>
<line>
predictive maintenance **
</line>
<line>
n*t always i*eal, as a devic* can receive mo*e
</line>
<line>
or
</line>
<line>
le*s
</line>
</par><par>
<line>
maintenance than n*cessar*, i* add*tion to being more expen*ive *han p*eventiv*. The
</line>
</par><par>
<line>
p*ogr*m bas*d on two strategi*s has produced *osit*ve results,
</line>
<line>
al*h*ugh *reventive
</line>
<line>
an*
</line>
</par><par>
<line>
pr*dictive mainte*ance
</line>
<line>
(P**) a** inconsistent in se*eral ways, have led *o a si*nifi*ant
</line>
</par><par>
</page><line>
reduction in equip*ent f*ilures.
</line>
<line>
Predictive mai*tenance (PdM) was a*d*essed by th* aut*ors Sh*may*eh, Awad a*d
</line>
<line>
Farhat (2*20) who pointed out *hat its use reduces the n*mber *f unplanned stop* of the
</line>
<line>
Rev. FSA, Teresi*a PI, v. 19, n. 8, ar*. 1*, p. 252-26*, ago. 2*22 www4.f*anet.c*m.br/revista
</line>
</par><page>
<par>
<line>
A. *. F. Mamed*, A. A. Resen*e
</line>
<line>
262
</line>
</par><par>
<line>
analyzed equ*pmen*, incre*sing its availab*lity. In this wa*, *t generates more p*ofit over time
</line>
<line>
and also *educ*s th* number of times the machine is disassembled, extending its useful *ife, in
</line>
<line>
a*dition t* r*ducing the cost of stock, *s i* is poss*ble to p*edict *a*lures.
</line>
<line>
T** authors' rese*rch Iadan*a *t al. (2019) *ifferentiate* from the others in
</line>
<line>
advo**ti*g t*e use of eviden**-based mainten*nce to m*nit*r maint*nance performance in a
</line>
<line>
ho*pit*l. Thi* m*thod *s*s t*e failure histo*y to carry out continuous **d i*proved
</line>
<line>
mo*itori*g of *urrent mainte*ance s*rategi*s. Th* firs* stage of the *es*arch was, t*er*fore, to
</line>
<line>
c*assify m*inten*nce *ork orders (a*aly*ing s*h*duled / preventive and correcti*e
</line>
</par><par>
<line>
maintenance). The sec*nd
</line>
<line>
s*ep was
</line>
<line>
to devel*p a set of key performance i*di*ators (KPIs).
</line>
</par><par>
<line>
From the an*lysis of the KPIs, th* authors conclude* t*at scheduled / *re*entive maint*na*ce
</line>
<line>
cannot pre*e*t a*l fa*l**es *r probl*ms be*ore they arise. The adoption of *he *vidence-b*se*
</line>
</par><par>
<line>
maintenance appro*** w**ld al*o* the hos*it*l to mo*itor *hanges over
</line>
<line>
t**e, b*in* *bl* to
</line>
</par><par>
<line>
compare wi*h pre*io*s resu*ts and, thus,
</line>
</par><par>
<line>
Another s*rategy us*d was the relia*ility-centered ma*ntenanc* app*oac* (RCM).
</line>
<line>
The authors Shamayleh, Awad and Abd*lla (2019) argued that it is more be*efic*a* and more
</line>
<line>
eco*omical *han pr*vent*ve mainten**ce. The RCM methodolog* is based on the *raditio*al
</line>
<line>
Failure Modes an* Effects Analysis (FMEA) and wa* used wit* a *o*us on reduc*ng
</line>
</par><par>
<line>
c*itic*lity. Throug* the maint*n*nce record
</line>
<line>
of medi*al equipment *or one *ear, the authors
</line>
</par><par>
<line>
*ought *o s*o* th* dep**d**ce and ineffici*ncy of preventi*e maint*nance ac*i**ties and how
</line>
<line>
the implemen*ation of the RCM will res*lt in a *or* adequate management program, in order
</line>
<line>
to minimize the ris* a*sociated *ith *ail*re.
</line>
<line>
The *m*C w*s also d*fended by Salim, Mazlan a*d Sa*im (20**), the author*
</line>
</par><par>
<line>
stre*sed *hat *t
</line>
<line>
is a reliable *ool and its princip*e *s to do the right job, at the ri*ht time,
</line>
</par><par>
</page><line>
acco*ding to t*e **uipme*t con*itions. However, it i* a lon*-*erm proc***, and many
</line>
<line>
org*niz*tions give u* or fail, mainly in mo*itoring and analyzing da*a. When performed
</line>
<line>
ef*i*iently, it will result in t*e elimination o* unne*ess*ry task* and the inclusi*n of actions to
</line>
<line>
address omi**i*n* a*d deficienc*es in ***nten*nce prog*ams.
</line>
<line>
4.1 M*thema*ical *ppro*c*
</line>
<line>
It w*s hi*hlighted by a study that most of the **thodologies used are emp**ical and
</line>
<line>
those based on mathematical modeling are scarce (K*a*af e* al., 2013). In the works included
</line>
<line>
i* this review, *ew pr*sente* ma**ematic*l analys*s; on*y tw* emphasize* th*s subject and
</line>
<line>
d**eloped mathema*ical models.
</line>
<line>
Rev. FSA, Teresina, v. 19, *.8, art. 12, p. 2*2-266, ago. 2022 www4.fsan*t.com.*r/***ista
</line>
</par><page>
<par>
<line>
Maintenance M*nagemen* in Hospi*al Equipm*nt: *ystemat*c Rev*ew
</line>
<line>
263
</line>
</par><par>
<line>
The autho*s Khalaf et al. (2013) prove* that t*e use of *at*em*tical *odel*ng to
</line>
</par><par>
<line>
a*alyze the effect
</line>
<line>
*f maintena*c* on the useful life o* *edical
</line>
<line>
equipment beneficial and is
</line>
</par><par>
<line>
r**eal*d that prev*nt**e maintenanc* had an i**act on it. The mathematical *o**l propose*
</line>
<line>
by the aut*ors was sim*l*ted in Matlab using real data from thre* devices.
</line>
<line>
The work of Khala* et al. (*015) poin*** out t*at several mathematical mod*ls hav* been
</line>
<line>
proposed to analyze the effect *f maintenance on indu*trial eq**pment, however they a*e
</line>
<line>
rarely us*d o* considered for medical devices. The au*h**s propos*d a math*m**ica* model
</line>
<line>
that *naly*es the probability of surviv*l of medi*al **ui*ment t*at combines the effects of
</line>
<line>
ra*dom failur** an* deterio*ation failure* by age, *si*g real mai*t*nance dat* a*d *imulated
</line>
<line>
i* Scilab.
</line>
<line>
Although this i* *ot a *athematical model spec*fi*ally, the au**o*s Sh**a*leh,
</line>
<line>
A*ad a*d Farh*t (*020) performed mathema*ical analy*is u*i*g the SVM f*reca*ting model,
</line>
</par><par>
<line>
w*ich compr*ses finding * hy*erplane, through
</line>
<line>
an equatio*, capable ** separating th* d*ta
</line>
</par><par>
<line>
classes into health* and defe**ive ones. The mod*l was based on four features and adj*sted to
</line>
<line>
an *ccept**le accur*cy of 96%, * true *o**tive rate of 93% an* a fal*e po*iti*e rate of 7%.
</line>
<line>
Fi*a*l*, the authors Pongra* et al., (2**9) *laim that it is impossible to imagine the
</line>
</par><par>
<line>
maintenan*e of medica* dev*ces without usi*g *he
</line>
<line>
p**ve*t*ve mai*tenance method. They
</line>
</par><par>
<line>
devel*ped
</line>
<line>
in their study a numerical w*y to fi*d the freq*e**y *f p*e*e*tive exams in
</line>
</par><par>
<line>
equipment. **iti*lly, th*y perfor*ed Pareto a*alysis *o clas*ify the causes *f failures and
</line>
<line>
defined pr*ventive *ainte*ance procedures. F*r the applica*ion of *h* mathe*ati*** formula
</line>
<line>
they u*ed values of *aximum rel*tive error, average t*me of fai*ure, inte*sity of system
</line>
<line>
fai*ures and average durati*n of * preventive e*am. Pe*forming f*re*as* ca*culations ensures
</line>
<line>
greater *quipme*t reliabil*ty and av*ilability, i*creasing th* overall quality of the *ystem.
</line>
<line>
5 CONCLUS*ONS
</line>
<line>
F*om the syst*matic review *f the l*tera*ure on the m**n type* of mainten*nce used
</line>
</par><par>
<line>
*y h**lthcar* organiz*tions
</line>
<line>
to m*nage hospital e**ipment, it is
</line>
<line>
possibl*
</line>
<line>
*o conclude that
</line>
</par><par>
</page><line>
preventive main*enan*e stand* out with *reater *pp**catio* in the sector. *o*t o* th* *ncluded
</line>
<line>
studies soug*t e*ficient *ays to op*imize it. I* addition, *ther methodologies have been
</line>
<line>
proposed, su*h as pred**tive maintenance, *vi*ence-based *aintena*ce and r*liab*lity-
</line>
<line>
centered m*int**ance (*CM), a*so *s a wa* *o obtain more efficie** results and mitigate t*e
</line>
<line>
risk of f*ilur**. The u*e of mat**mat*cal modeling proved to be e**icient to assist *ain*ena*ce
</line>
<line>
R*v. FSA, Teresina PI, v. 19, n. 8, art. 12, p. 252-26*, ago. 2022 ww**.fsanet.com.b*/revis**
</line>
</par><page>
<par>
<line>
A. L. *. Ma***e, A. A. Resend*
</line>
<line>
264
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</par><par>
<line>
*ecision-making, how*v*r it was observed in f** stu*ies t**t even *ention*d *hat this
</line>
<line>
approach is scarce ** the *ield of maintenance of hospital eq**pm*nt,
</line>
<line>
*he use *f str*t*gi** that are b*se* on h*stori*al *quipment *a*a to an*lyze *he cause
</line>
<line>
of the **ilures an*, then, estab*ish mainte*ance interva*s, prove* to be efficien* in *he s*udies
</line>
<line>
in which they wer* explored. To**ther with math***tical modeling, the* can brin* positive
</line>
<line>
resu**s to organ*z*t*o*s, provi*i*g great*r *vaila*ilit* of equipment, incr*asi** the re*iability
</line>
<line>
of p*tients and staff, in addition t* reducing maintenance c*st*. To reinforce the evi*ence,
</line>
<line>
fut**e stu**es can be deve*oped expl*rin* this ar*a.
</line>
<line>
Acknowledg*men*s
</line>
<line>
The **r*t author *han*s CAP*S for your mast*r's degree scholarships in Br*zil. *hey
</line>
<line>
a*so than* the Laboratory *f Mechani*al Man*facturing *f the Feder** Un*v*rsit* of Catalã*.
</line>
<line>
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Lecture*
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on
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Biomedic*l
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Engin*ering,
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45,
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pp.
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1-83.
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do* :
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Rev. FSA, *eres*na PI, v. 19, *. 8, a*t. 12, p. *52-266, ago. 202*
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**w4.fsanet.co*.br/rev*sta
</line>
</par><page>
</document><par>
<line>
A. L. F. *amede, A. A. Re*ende
</line>
<line>
266
</line>
</par><par>
<line>
10.2200/S004*0ED1*01Y2**209BME04*.
</line>
</par><par>
<line>
Como *eferenciar este Artigo, *onf*rme ABNT:
</line>
<line>
M*M*DE, A. L. F; *ESE*D*, A. A. *ainte*ance Management *n *ospital Equipmen*: Syste*atic
</line>
<line>
Review. Rev. FSA, Tere*ina, *.19, n. 8, art. 1*, p. 252-2*6, ago. 20*2.
</line>
</par><par>
<line>
Contribu*ção dos Au*ores
</line>
<line>
A. L. F. M*mede
</line>
<line>
A. A. Resen*e
</line>
</par><par>
<line>
1) concepção e planejament*.
</line>
<line>
X
</line>
<line>
X
</line>
</par><par>
<line>
2) anál*se * interpretaç*o dos dados.
</line>
<line>
X
</line>
<line>
</line>
</par><par>
<line>
3) e*aboração do rascunho ou na revisão crítica do co*teúdo.
</line>
<line>
X
</line>
<line>
X
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</par><par>
<line>
4) participação na *provação da versão final *o manuscrito.
</line>
<line>
X
</line>
<line>
X
</line>
</par><par>
</page><line>
Rev. FSA, Te*esina, v. 19, n.8, ar*. 1*, p. 252-266, ago. *0**
</line>
<line>
www4.fsanet.com.br/rev*sta
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