One final task. Sergeant Jones must evaluate the pricing on different quotes to

Question

One final task. Sergeant Jones must evaluate the pricing on different quotes to select vendors for supplies to spruce up Fort Detrick’s playground. Calculated supplier performance indexes indicate that Company A has a SPI of 1.31, Company B a SPI of 1.25, Company C has a SPI of 1.43, and Company D has a SPU of 1.32. (Sergeant Jones has instructions not to worry about an adjusted SPI). The below table contains the quote information.

Product

Company A

Company B

Company C

Company D

Pea Gravel

$9.25 per 1000 lbs

$18.58 per ton

$9.10 per 1000 lbs

$0.95 per 100 lb bag

Mulch

$3.50 per 100 lb bag

$17.70 per 500 lbs

$0.04 per pound

$63.00 per ton

Sand

$21.00 per yard

$21.89 per yard

$21.50 per yard

$20.99 per yard

Washed stone

$23.00 per ton

$0.02 per pound

$10.01 per 1000 lbs

$1.97 per 100 lb bag

Everything else being equal, which supplier offers the best deal for:

(2 points) Pea gravel?

(2 points) Mulch?

(2 points) Sand?

(2 points) Washed stone?

Your answer must include the supplier AND the winning quote for the product!

(2 points) What if Sergeant Jones could only pick one supplier? Which one should he select and why?

Product

Company A

Company B

Company C

Company D

Pea Gravel

$9.25 per 1000 lbs

$18.58 per ton

$9.10 per 1000 lbs

$0.95 per 100 lb bag

Mulch

$3.50 per 100 lb bag

$17.70 per 500 lbs

$0.04 per pound

$63.00 per ton

Sand

$21.00 per yard

$21.89 per yard

$21.50 per yard

$20.99 per yard

Washed stone

$23.00 per ton

$0.02 per pound

$10.01 per 1000 lbs

$1.97 per 100 lb bag

Explanation / Answer

Staff responsible for purchasing should take into account any relevant local policy, and ensure that the product meets the requirements of clinical staff and that the accuracy is adequate for the clinical situation in which it is to be used.
Relevant information should be obtained from the manufacturer before purchase, including clinical validation, standards complied with, manuals available, warranty details, availability of training for users, and maintenance contracts.
It is also important to take into account total costs, including training, consumables and maintenance. The selection of disposable or re-useable cuffs should consider the cost differentials, supply logistics, infection control and the environmental impact of disposal.
Purchasers should be aware that blood pressure monitors for clinical use should be CE marked to show compliance with the Medical Devices Directive . Manufacturers may demonstrate compliance with the essential requirements of the Directive by applying the appropriate harmonized. Although it is not mandatory for a device to comply with these standards, their requirements are considered to be ‘state of the art’. A manufacturer will either comply with them or carry out a risk assessment to demonstrate an equivalent level of safety.
Both purchasers and staff who use these devices should be aware that recommendations have been published by the Independent Advisory Group on Blood Pressure Monitoring in Clinical Practice regarding the purchase and use of blood pressure monitors.
When new medical devices are introduced it is important that members of staff are trained to ensure they are aware of the equipment’s limitations and can recognise artefacts. General advice on the selection, purchasing, maintenance and the need for user training are given in the MHRA’s publication ‘Managing Medical Devices’
All blood pressure measuring equipment should be regularly checked and calibrated in accordance with the manufacturer’s instructions. These maintenance recommendations vary depending on the type, frequency and location of use. However, it should be noted that some of those originally designed for use in the home may be difficult to calibrate without returning to the supplier.
Cuffs and their hoses should be regularly inspected and replaced as necessary. Excessive air leakage from damaged cuffs, hoses and tubing connectors may reduce the accuracy of the readings. Both disposable (single patient use) and reusable cuffs are available. Re-usable cuffs should be cleaned in accordance with the manufacturer’s instructions, ensuring that cleaning fluid does not enter the cuff bladder or hoses. Particular concern over the lack of maintenance of blood pressure measurement devices, both in the community and acute hospital settings, has been highlighted . Faulty cuffs, hoses, aneroid gauges and mercury manometers can all lead to erroneous blood pressure measurements, with significant effects on patient care.

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