Performance Verification Procedure - CareFusion Alaris GP Technical & Service Manual

Performance Verification Procedure

Model / Serial Number:
Hospital Name / Reference:
Inspection Physical inspection and clean
Check all functions in PVP Work Flow
Enter access code 212 and go to PVP Work Flow
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CH3
Self Test
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Setup
Set rate to zero (or lowest value possible), clear Volume Infused and VTBI
Class I Type CF
Test in accordance with the standard
EN 60601-1 and test equipment
Electrical Safety
operation manual.
TestS
Verification
Performed
By ____________________________
Sign
CHX indicates the chapter number in the Technical Service Manual (TSM) - 1000SM00013.
E.G. CH2 = Refer to TSM Chapter 2.
CH3
Software Versions
Date/Time
Serial Number
Door Frame
Safety Clamp
Sear
Audio Test
Chequerboard
LED's
Keypad
Nurse Call
RS232 Loop Back
Pumping Efficiency Test
- Time taken = 2 minutes or less
Downstream Occlusion Pressure Test
- Occlusion alarm = 500 ± 100 mmHg
Alarms Functionality
Volumetric (Accuracy Test) Calibration
- Delivery = 20 ml ± 0.6 ml (3%)
1000SM00013 Iss. 4
Service Order / Inventory Number:
Software Version:
Test results are stored:
• Electronically
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• Print-out ¨
• Other
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____________________
____________________________
Print
39/80
Alaris® GP Volumetric Pump
Preventative Maintenance
______ minutes ______seconds
______________mmHg
______________ml
PASS / FAIL
_____________________
Date