When surgical techs pull instruments and supplies for procedures,
they scan barcodes on a case cart and then scan each instrument tray
they place in the cart. The tracking system links the cart and its con-
tents to a patient's identification number, and to the procedure and
OR in which it will be used. The system prints out a count sheet that
lists every item needed for a case and a label that sticks to the outside
of instrument trays. The label notes the name and number of the tray,
the case in which it will be used and missing supplies.
Staff can log into the system to determine when and where instru-
ments were used, and on which patients. "That ability to trace back to
specific details of instrument use is invaluable when conducting root-
cause analyses of post-op infections," says Ms. Houston.
Report card system
Real-time tracking software is a slick way to manage your instrument
inventory, but staff at Valley Health tapped into the technology's full
potential when case carts began arriving in central sterile without
lids securely attached and with still-soiled instruments haphazardly
tossed back into random trays.
Disorganized case carts and improperly cared for instruments are
more than just a nuisance. Instruments that aren't wiped down and
treated with an enzymatic spray at the point of use are harder to clean
before sterilization and more likely to be contaminated when they're
returned to the OR. Sharps that aren't strung and trays that aren't
properly stacked put techs at risk of a cut finger or broken toe.
"When one of our techs opened a case cart, a tray fell out and just
missed her foot," says Nancy Mulligan, BSN, RN, CNOR, a nursing
manager at Valley Health System. "She wasn't injured, but she could
have easily been."
Members of the health system's OR team weren't returning disorgan-
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