Standards for general practices

General practice module

Criterion GP5.2 – Practice equipment

        1. Criterion GP5.2 – Practice equipment

Indicator


GP5.2 A Our practice has equipment that enables us to provide comprehensive primary care and emergency resuscitation, including:

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

GP5.2 B Our practice maintains our clinical equipment in accordance with each manufacturer’s recommendations.

GP5.2 C Our practice has one or more height-adjustable beds.

GP5.2 D Our practice has timely access to a spirometer and electrocardiograph.

GP5.2 E Our practice has a defibrillator.

Why this is important

You need to have equipment that enables your practice to provide comprehensive primary care and emergency resuscitation.

Equipment needs to be maintained so that it is always in good working order whenever it is needed.

Research shows that pulse oximeters are useful in a general practice to diagnose and assess hypoxia.16 Other research shows that (despite the efforts of medical practitioners, policy makers and consumer advocates) people with a disability continue to experience poorer health outcomes in a range of areas when compared to the broader population.17 One reason for these poorer health outcomes has been the lack of height-adjustable examination beds in general practices, resulting in fewer opportunities for patients with disability to have thorough and dignified clinical examinations.17 Using height-adjustable beds may also reduce workplace injuries because it may reduce the need for practitioners to help patients onto an examination bed that is too high.

Having an automated external defibrillator (AED) in your practice can reduce the risk of fatality from cardiac arrest.18 Although sudden cardiac arrest is rare in general practice facilities, a GP needs to be able to have a lead role in resuscitation in the event it does occur.19

Most cases of sudden cardiac arrest are due to ventricular fibrillation that can be returned to a normal sinus rhythm with the use of an AED. Using an AED is relatively straightforward and cannot cause harm, as they analyse the cardiac rhythm and will deliver a shock only if necessary. Survival rates after sudden cardiac arrest drop by 7–10% for every minute without CPR and defibrillation.20 CPR alone has a 5% survival rate but CPR combined with early defibrillation increases the survival rate to 50%.21

Meeting this Criterion

Range of equipment

Your practice must have all the equipment necessary to provide services that meet local needs and support the procedures performed in the practice. This may mean that you have some equipment that other practices may not need, but is relevant to your location or patient population.

PPE can include masks, plastic aprons, gowns, goggles/glasses, face shields, gloves and swabs.

Maintaining clinical equipment

Your practice must ensure that all clinical equipment is maintained and in working order at all times. You could maintain a register that lists all clinical equipment in the practice, along with schedules for servicing and maintenance.

Equipment that requires calibration, or which is electrical or battery-powered (eg electrocardiographs, spirometers, autoclaves, vaccine refrigerators, scales and defibrillators), must be serviced regularly in accordance with the manufacturer’s instructions so that it remains in good working order. You could keep receipts from companies that have provided external equipment testing and calibration so you can schedule regular maintenance checks. You could also maintain a checklist of equipment used in your consultation rooms so you can record dates of servicing and regularly check that maintenance is up to date.

You must store all hazardous materials, including liquid nitrogen and oxygen, in accordance with work health and safety regulations.

Height-adjustable beds

Follow these guidelines when purchasing height-adjustable beds:

  • Preferred minimum range of height adjustment: 45–95 cm
  • Preferred maximum weight capacity: 175 kg
  • Preferred minimum width of table: 71 cm
  • Preferred minimum length: 193 cm
  • Number of sections: two (so the head section can be raised)

You could also consider purchasing other features and equipment for your height-adjustable beds, such as stirrups for gynaecological examinations.

Electrocardiograph and spirometer

You must have timely access to an electrocardiograph and a spirometer. You can purchase this equipment or make arrangements with a service that has this equipment (eg a nearby hospital) so you have timely access to the equipment.

If you have an electrocardiograph or spirometer onsite, the clinical team must be properly trained to use and maintain the equipment, and analyse the results.

You must determine what ‘timely access’ means for your practice, based on clinical need and what peers would consider an acceptable timeframe.

Automated external defibrillator

You must decide whether your practice needs to install an AED, based on the risks of harm from cardiac arrest, by considering:

  • the location of the nearest AED, hospital and other emergency services
  • the number and composition of practice staff members, patients and other people who visit your practice (an AED is useful in workplaces that are visited by many members of the public20)
  • records of injuries, illnesses and near misses.

If you have an AED:

  • it must be maintained according to the manufacturer’s specifications
  • the practice team must be properly trained to use and maintain it
  • it must be placed where it is clearly visible and accessible, and not exposed to extreme temperatures
  • there must be clear signs to indicate where it is located.

Equipment for practices providing telehealth

In addition to using telephones (audio only) for telehealth, you can hold video consultations using freely available software with video/call functionality across a variety of hardware (eg computer, tablet, smartphone), or invest in specific video hardware and software systems. Practices that have a high volume of videoconferencing (not only for telehealth video consulting) might find it worthwhile to invest in more specific videoconferencing hardware and/or software.

Up-to-date MBS guidance on technical specifications for equipment and software can be found online. 

Ensure the system you choose meets the requirements of the MBS item descriptor and applicable laws for security and privacy. 

Consulting with the practice team

In accordance with Safe Work Australia recommendations,22 consider consulting with the practice team before making decisions on health and safety matters, and before deciding what new facilities the practice needs.

Meeting each Indicator

GP5.2 A Our practice has equipment that enables us to provide comprehensive primary care and emergency resuscitation.

You must:

  • have all required equipment.

You could:

  • maintain a checklist of equipment that you need in consultation rooms
  • maintain an equipment register, including all of the required equipment
  • perform a regular audit of the practice’s equipment.

GP5.2 B Our practice maintains our clinical equipment in accordance with each manufacturer’s recommendations.

You must:

  • demonstrate that you keep all clinical equipment in good working order in accordance with manufacturers’ recommendations.

You could:

  • keep a maintenance log that includes receipts from any external companies that test and calibrate equipment.

GP5.2 C Our practice has one or more height-adjustable beds.

You must:

  • have at least one height-adjustable bed.

You could:

  • have a height-adjustable bed in each consultation space.

GP5.2 D Our practice has timely access to a spirometer and electrocardiograph.

You must:

  • demonstrate that you have timely access to a spirometer and an electrocardiograph.

GP5.2 E Our practice has a defibrillator.

You could:

  • have a defibrillator
  • conduct a risk assessment to determine if you need a defibrillator onsite
  • educate the practice team so they know how patients can access defibrillation when required.

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