Your browser has 'Cookies' disabled, alert boxes will continue to appear without this feature.

Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standard 5.2 Equipment for comprehensive care

Our practice provides medical equipment and resources that are well maintained and appropriate for comprehensive patient care and resuscitation.

Criterion 5.2.1

Practice equipment

Our practice has access to the medical equipment necessary for comprehensive primary care including emergency resuscitation.

Indicators

► A. Our practice has equipment for comprehensive primary care and emergency resuscitation including:

  • auriscope
  • blood glucose monitoring equipment
  • disposable syringes and needles
  • equipment for resuscitation, equipment for maintaining an airway (for children and adults), equipment to assist ventilation (including bag and mask), IV access, and emergency medicines
  • examination light
  • eye examination equipment (eg. fluorescein staining)
  • gloves (sterile and nonsterile)
  • height measurement device
  • measuring tape
  • monofilament for sensation testing
  • ophthalmoscope
  • oxygen
  • patella hammer
  • peak flow meter
  • scales
  • spacer for inhaler
  • specimen collection equipment
  • sphygmomanometer with small, medium and large cuffs
  • stethoscope
  • surgical masks
  • thermometer
  • torch
  • tourniquet
  • urine testing strips
  • vaginal specula
  • visual acuity charts
  • X-ray viewing facilities.

► B. Our practice has timely access to a spirometer and electrocardiograph.

► C. Our practice can demonstrate that the equipment we use is sufficient for the procedures we commonly perform.

► D. Our practice can demonstrate how we maintain our key equipment, according to a documented schedule.

E. Our practice has a pulse oximeter.

Explanation

Key points

  • Practices need to have the necessary equipment for comprehensive primary care and emergency resuscitation
  • Equipment that requires calibration or that is electrically or battery operated requires regular servicing in accordance with the manufacturer’s instructions.

Range of equipment

Practices need to have the necessary equipment for comprehensive primary care and emergency resuscitation. To meet this criterion, equipment must be in good working order. There is a wide range of equipment that practices may need in order to provide services which meet local needs, serve the nature of the practice and support any procedures the practice performs.

All equipment must be in good working order

Equipment that requires calibration or that is electrically or battery powered (eg. electrocardiographs, spirometers, autoclaves, vaccine refrigerators, scales or defibrillators) needs to be serviced on a regular basis in accordance with the manufacturer’s instructions to ensure it is maintained in good working order.

It is useful for practices to maintain a register of equipment in the practice, which includes the schedules for servicing or maintenance.

Automated external defibrillator (AED)

There is evidence, both internationally and in Australia, to suggest that immediate defibrillation significantly improves the chance of survival after cardiac arrest. Although cardiac arrest in the general practice setting is a rare event12, the difference in outcomes between early defibrillation (within 8 to 9 minutes) and later defibrillation is very significant (10% increase in mortality for each minute from the time of the arrest). Practices may choose to purchase an automated external defibrillator in view of the significant improvement in patient outcomes achieved by early defibrillation.

Electrocardiograph and spirometer

Practices need timely access to an electrocardiograph and a spirometer. Some practices will choose to purchase this equipment and other practices will choose to make arrangements for timely access to the equipment (eg. arrangements with a pathology service or nearby local hospital).

For practices which have an electrocardiograph or spirometer on site, it is important that staff are properly trained to use and maintain the equipment and analyse results.

The assessment of ‘timely’ access needs to be based on clinical need and what peers would consider to be an acceptable timeframe.

Pulse oximeters

Pulse oximeters have been demonstrated to be useful in the general practice setting13 for the assessment of hypoxia and, in some instances, to identify unsuspected hypoxia.

Hazardous materials

All hazardous materials including liquid nitrogen and oxygen should be stored securely.

References

  1. Hudson L, Jacobs I. Defibrillators – their use in general practice. Aust Fam Physician 2008;37:63–4.
  2. Potter VAJ. Pulse oximetry in general practice: How would a pulse oximeter influence patient management? Eur J Gen Pract 2007;13:216–20.

Services providing care outside normal opening hours

Services providing care outside normal opening hours need to be able to demonstrate how the minimum equipment requirements outlined in this criterion would be accessed when needed.

Standard 5.2 Equipment for comprehensive care

Our practice provides medical equipment and resources that are well maintained and appropriate for comprehensive patient care and resuscitation.

Criterion 5.2.1

Practice equipment

Our practice has access to the medical equipment necessary for comprehensive primary care including emergency resuscitation.

In a nutshell

Your health service needs to have the necessary equipment to provide comprehensive primary care to its community and to perform emergency resuscitation when required. The equipment that is necessary for your health service will partly depend on the health profile of your local community, and would include equipment to provide chronic and acute care. See Table 5.4 below for a list of the equipment that all health services should have. Equipment that requires calibration or is electronically operated needs to be serviced regularly and in accordance with the manufacturer’s instructions.

Key team members

  • Health service manager
  • Clinic manager

Key organisational functions

  • Service and program planning
  • Equipment register
  • Equipment maintenance records/schedules

Indicators and what they mean

Table 5.4 explains each of the indicators for this criterion. Refer to Criterion 5.2.1 Practice equipment of the Standards for general practices for more information and explanations of some of the concepts referred to in this criterion. 

Table 5.4 Criterion 5.2.1 Practice equipment
IndicatorWhat this means and handy hints
▶ A. Our practice has equipment for comprehensive primary care and emergency resuscitation including:
  • auriscope
  • blood glucose monitoring equipment
  • disposable syringes and needles
  • equipment for resuscitation, equipment for maintaining an airway (for children and adults), equipment to assist ventilation (including bag and mask), IV access, and emergency medicines
  • examination light
  • eye examination equipment (e.g. fluorescein staining)
  • gloves (sterile and non-sterile)
  • height measurement device
  • measuring tape
  • monofilament for sensation testing
  • ophthalmoscope
  • oxygen
  • patella hammer
  • peak flow meter
  • scales
  • spacer for inhaler
  • specimen collection equipment
  • sphygmomanometer with small, medium and large cuffs
  • stethoscope
  • surgical masks
  • thermometer
  • torch
  • tourniquet
  • urine testing strips
  • vaginal specula
  • visual acuity charts
  • X-ray viewing facilities.
Equipment required for comprehensive primary care and emergency resuscitation needs to include everything listed for this indicator. In addition, it needs to be stocked in accordance with community needs, and to support the procedures that are regularly performed at your health service.

This means, for example, that in communities with high incidence of chronic diseases, equipment at the health service will be different from communities with high incidence of tropical diseases. Communities close to hospitals will have different needs compared to remote communities in terms of the type of emergency equipment and medication.

Similarly, equipment may vary between seasons (wet and dry) and therefore may need to be stored and maintained differently at different times of the year (for example, high humidity may affect certain equipment like the HemoCue®).

It is important that your health service understands the needs of its community and plans appropriately in terms of health service equipment for comprehensive primary care and emergency care.
▶ B. Our practice has timely access to a spirometer and electrocardiograph. Timely access to ECGs and spirometry is important for the appropriate diagnosis and management of certain conditions. Although not all clinics need on-site access to this equipment, all clinics need timely access to it.

If your health service chooses to have an ECG and spirometry machine, your staff will need training on how to use it and maintain it and, of course, to analyse the results.

Rural and remote health services may need to have this equipment on site for appropriate emergency, acute and ongoing care.
▶ C. Our practice can demonstrate that the equipment we use is sufficient for the procedures we commonly perform. The healthcare needs of Aboriginal and Torres Strait Islander peoples are different to those of other patient populations. Factors such as remoteness and cultural background have a huge influence on patient presentation and the types of conditions and problems managed in ACCHSs.

As a result, ACCHSs may regularly perform procedures that are not common in other areas of general practice. Your health service therefore needs to demonstrate that the equipment it uses is adequate for the diagnosis and treatment of its patients and their conditions.
▶ D. Our practice can demonstrate how we maintain our key equipment, according to a documented schedule. All equipment needs to be in good working order and serviced on a regular basis.

It is highly recommended that your health service maintain a register of equipment. The register can then be used to document the service and maintenance schedules for each item.

It is important that this register is regularly updated and maintained to ensure that manufacturers’ instructions are followed, and equipment can be kept in good working order at all times.
E. Our practice has a pulse oximeter. Your health service should have a pulse oximeter, and keep it in good working order. Relevant staff need to know how to use it properly.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can ensure access to medical equipment necessary for comprehensive primary care including emergency resuscitation. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

The clinic has all the equipment listed in Table 5.4 above available for comprehensive primary healthcare, as well as emergency resuscitation equipment.

In addition, the clinic regularly conducts community health research, using external reports and databases as well as local data obtained from clinical audits and community consultations, to better understand the present and future health issues of the community. Consequently, it makes sure that it is planning ahead to ensure it has the necessary equipment to provide regular primary healthcare services for projected needs and to manage health emergencies. For example, because presentations to the GPs include a high number of cases of diabetes, as well as otitis media and anaemia in patients under 5 years, the service has tympanometry, HemoCue® and/or HbA1c machines to improve the care and follow up of patients with these conditions.

Because of its strong focus on preventive health, the service makes sure it has the necessary equipment to screen for chronic conditions common to its community and for preventive care.

The service’s resuscitation equipment is checked weekly by the nurses and recorded in a log. The equipment is restocked immediately after use. In addition the remote clinic has emergency equipment in the ambulance and grab packs for obstetric and other emergencies, such as traffic accidents.

The visual acuity charts are both in pictorial and standard letter format, with the pictorial format being used for children and adults who have difficulty reading.

Clinics have access to both an electrocardiograph and a spirometer. They have adult and child pulse oximeters available for use by staff members.

Equipment is maintained according to a documented maintenance log, which includes when the equipment is due for service or calibration. It has a task list for the checking of oxygen cylinders and calibration of the electrocardiograph.

Staff are trained in the proper use of medical equipment and the analysis of results. When interviewed, the service’s staff members can describe the commonly performed procedures and the special equipment (in addition to that in the standard list) that is used.

Showing how you meet Criterion 5.2.1

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how it meets the criterion.

  • Through the use of direct observation.
  • Maintain a checklist for consultation room equipment.
  • Through the use of staff interviews.
  • Maintain an equipment register.
  • Keep a maintenance log.
  • Maintain a task list.
  • Keep receipts from any external equipment testing and calibration companies.
Search Standards Advanced Search
Search Interpretive guide Advanced Search

The Royal Australian College of General Practitioners

General enquiries

Opening hours 8:00 am-8:00 pm AEDT

1800 4RACGP

1800 472 247 | +61 (3) 8699 0300 (international)

Follow us on


The Royal Australian College of General Practitioners (RACGP) ABN 34 000 223 807
RACGP House, 100 Wellington Parade, East Melbourne, Victoria 3002 Australia

Terms and conditions | Privacy statement