Steps in the Management of Surgical Instrumentation

Step 5:

Utilize an instrument count sheet system under the management of one person, preferably a manager or an experienced instrument tech; do not allow everyone to have access. There are programs in the marketplace that are free or can be negotiated; your primary instrument vendor is often the first place to start. In most cases you may need to commit volume to one vendor to get the program at no cost.

Instrument management can be best served by budgeting for an integrated system that can be part of an OR integration package to allow surgical staff the ability to view instrument sets in the OR and in SP. Instrument tracking systems are often interfaced with the OR scheduling system, providing real-time utilization.

All instrument tracking system providers will use your Word or Excel count sheets and build the database for you. In some cases the vendor will complete an inventory and build the data base from that. Make sure you standardize your count sheets to one primary vendor with a secondary for those hard-to-get instruments. Do not substitute from another vendor unless you change the count sheet to match the instrument.

You will minimize errors and improve employee training by keeping your count sheets accurate, following the vendor catalog numbers. Granted, the catalog numbers will wear off the instrument over time if extensive repassivation is required due to poor decontamination processes. Keeping the database descriptions standardized and simple will also reduce errors as well as and speed up training.

Do not allow made-up names or pet names; use the proper industry name of the instrument, and do not use the instrument manufacturer’s technical descriptions. Start all descriptions with common nouns, such as scissor, needleholders, forceps, retractors, and so on. Count sheets that follow a specific organization that can be standardized will greatly improve the assembly process. The proper noun is to follow with type and size as follows, “Scissors Mayo CVD 6.5.” Keep it simple!

Adding the vendor catalog number to the end of the description will also help. Keep a master copy with a picture on file along with sterilization instructions in SP for sets that require additional attention. All changes are to be signed-off and kept on file with the original.

Special note: An instrument tracking system in place of a count sheet system can provide additional utilization information but requires IS justification to purchase. There is much to consider when moving to a tracking system. Purchasing a tracking system to track single instruments is not adequate justification.

Make sure you understand what extra steps there are before undergoing the purchase. If you are planning to use the system to prove that it is the OR that is losing instruments, then do not proceed any further. Casting blame is not the answer; controlling and managing the surgical instrument inventory eliminates the blame game and reduces lost instruments.