Ergonomically speaking, your case carts should be something that
your staff can easily work with. Their weight is of course a big concern,
but so is their height. A nurse who's 5 feet tall won't be able to see over
the 5-foot cart she's attempting to navigate down the hallway. There is
an argument to be made, however, that it's easier on the back to
retrieve a heavy tray of orthopedic instruments from a higher shelf than
it is to lift it from a crouching posture.
A cart should be cooperative in its maneuverability. The wheels
shouldn't put up a fight when you're pushing them down the hall or
around a corner, and they should feature locks or brakes to keep
them where they're parked.
Speaking of parking: How much space does your facility have to
accommodate carts' OR use, reprocessing and between-case storage?
Cart size also factors in here. The footprints of tall carts, more vertical
than horizontal, economize on floor space. Shorter, wider carts, on
the other hand, can double as tabletops on which to set up cases.
Ideally, implementing a case cart system will also include budgeting
space for a cart washer, which is much more efficient timewise than
manually disinfecting them.
The people behind the process
The investment of time and money into a new fleet of case carts may
be a worthwhile occasion to reconsider how they're used, particularly
in terms of which department will be maintaining the system by
pulling the cases and pushing the carts to the OR.
Some facilities are making a move toward assigning the task to
their sterile processing techs. This makes a lot of sense for 2 rea-
sons. First, anyone can read the menu of a surgeon's preference
card, and the SPD is less expensive labor. Where would you rather
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