9.
Regular preventive maintenance must be scheduled.
10.
An inventory of spare parts for field repairs should be obtained and
maintained.
ll.
Replacement
of equipment
and
instrumentation
should be planned
and
budgeted for an average life of 3 to 5 years. Some instruments may need
replacement even earlier due to the effects of high humidity and salt
from the sea spray.
12.
As superclinics become staffed with Medex or higher level personnel,
they should be equipped to do stool exams for parasites, complete blood
counts, urinalysis, and blood sugars.
3.
Radiology
Present System
Diagnostic x-ray facilities are operational at both Majuro and Ebeye.
Fixed
instruments
processed by hand.
are modern;
portable
equipment
obsolete.
only.
are
X-ray technicians were trained initially in Saipan and
are now giving on the job training to their assistants.
studies
Films
Films
ordering physician.
are
interpreted
and
They do non-invasive
brief reports written
by the
Super clinic x-ray facilities are not operational.
Recommendations:
Shielding in x-ray examination areas should be extended sufficiently to
prevent patients and employees in adjacent areas from being exposed to more
than the allowable dose.
of x-ray personnel
Film badge services or other appropriate monitoring
should be provided.
Arrangements should be made for
periodic review of technical quality and accuracy of interpretation of films.
4.
Supplies
Up to the present time the hospital at Majuro has been the central depot
for all supplies both organizationally and physically.
With the suggested
upgrading of health services at the primary and secondary levels this will
become increasingly more difficult. As a result it has been suggested that a
completely separate division be established to handle all the supplies of
both the primary and secondary health services.
While this represents a
change organizationally it is suggested that the physical location of the
central
depot
remain at the Majuro Hospital.
This would mean that the
hospital would no longer order supplies directly from the suppliers but would