Steps in the Management of Surgical Instrumentation

Step 8:

Utilize the OR scheduling system to access set usage; the information is there, you just need to know how to retrieve it. In some cases there is a report writer in the system that can do just that. Hopefully your OR has a dedicated IS person responsible for the system. Knowing the utilization will help you to purchase additional sets or move sets to other surgery related services such as out patient surgery center. A tracking system will also provide the same information.

Step 9:

Utilize on-site instrument repair services and get to know your sterilizer repair professionals. These people can educate your staff and help you solve all kinds of problems. They can also teach you about repairs and preventive maintenance, along with getting you in contact with custom manufacturers that can fix or make just about any surgical instrument.

Step 10:

Teach your staff how to do PM on light cords, rigid scopes, and air-powered instruments. Purchase a simple CORBA light source and a Rigid-Scan rigid scope checker and start checking fiber optic light cords as well as rigid scopes prior to sterilization. These two devices will help you eliminate complaints regarding both items by identifying the problem before it shows up on the sterile field. Be proactive and complete preventive maintenance as often as possible. It also goes without saying, do not forget to conduct routine PM on scissors and needleholders.

Step 11:

Do not allow surgeon-named trays, which generally increases flash sterilization due to lower inventory levels. In most, if not all hospitals, there is almost always one physician-named tray which is flash sterilized from patient to patient. By doing so your hospital is supporting routine use of flash sterilization. This process must stop because of the risk to patients, reduced instrument life, poor manual wash, and increased time added to the daily room turnover. Routine flash sterilization use is not supported by a number of industry organizations, including AORN, the Association for the Advancement of Medical Instrumentation (AAMI), the American National Standards Institute (ANSI), the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the International Association of Healthcare Central Service Materiel Management (IAHCSMM). The focus must be on the instrument inventory which, if managed correctly, will reduce and even eliminate the need for flash sterilization altogether. Standardize your trays and purchase enough so that your surgeons can complete the cases without delay.