sterile processing
sterile processing
By David Taylor , MSN , RN , CNOR ; Kristina Pirollo-Ketchum , AA , CRCST , CHL ; and Albert Huether , MBA , CRCST
Managing Loose Devices to Reduce Workload , Increase Throughput
Although the roles and responsibilities of sterile processing ( SP ) professionals can vary from one location to the next , their primary duties involve processing instrumentation and reusable medical equipment by removing gross contaminants ( decontamination ), inspecting and reorganizing instruments into their appropriate trays , sets and / or peel packs ( reassembly ), sterilizing or high-level disinfecting each item according to the manufacturers ’ instructions for use ( IFU ); and storing that instrumentation and medical equipment for future use ( sterilization and storage ). Still , broken , missing or inappropriately prepared instruments — known as tray defects — can be a frequent problem for surgical and procedural teams , causing delays and negative patient outcomes .
On any given day , SP professionals can process thousands of surgical instruments over the course of a 24-hour period , depending on their organizations ’ location and size . To process those items , SP technicians must work efficiently to ensure each instrument tray or set is assembled correctly for reuse . Unfortunately , many factors can impact an SP technician ’ s ability to perform their roles properly . For example , not all instruments are returned inside their proper tray , which can contribute to device damage and loss . Such issues must be corrected during the reassembly phase to prevent future problems for the operating room ( OR ) or procedural areas .
During the assembly phase , SP technicians often address issues with damaged or missing devices by replacing them with loose instruments in the organization ’ s inventory . These instruments are often located in the assembly areas in drawers , cabinets , containers , case carts or peg boards . Many loose instruments in inventory are disorganized , often mixed and in disarray , which makes finding a replacement instrument time consuming or , in some cases , impossible . Additionally , the condition of loose instruments may not always be much better than the devices they are replacing . Inappropriate storage practices can damage loose instruments , leading to lost items , costly replacement , and an increased risk for contamination . Redesigning loose instrument inventories can create opportunities , such as helping reduce instrument and instrument set defects , eliminating waste , over production and wasted steps , and speeding up production times .
A well-maintained physical environment is critical for managing loose instruments effectively and consistently . With demanding and sometimes daunting workloads , the last thing SP technicians need is to waste precious time searching for a device to complete a set or locating an essential instrument during an emergency . Standardization and systemization help the process and hold SP team members accountable for the work they perform .
When exploring ways to improve loose instrument inventory management , it is necessary to inventory all devices that are extra or deemed loose in inventory . Once inventoried , SP leaders can determine whether the available extra devices are enough to support the surgical specialties and procedural volume ( if not , it will be necessary to budget for and purchase more ). After inspection , damaged or malfunctioning instruments should be thoroughly repaired and maintained ( as needed ). It is important to permanently remove from inventory any instruments that are nonrepairable . Instruments of suboptimal condition that are not removed could find their way into an instrument set for patient use , adding to defect data and , most importantly , risk to patient safety .
Once all loose instruments are inventoried , purchased and / or repaired , they must be properly stored . There are multiple options for sterile processing departments ( SPDs ), so it is important to choose what is right for one ’ s own organization and to solicit feedback from employees across all shifts . Keep in mind , any storage solutions chosen must be sturdy , meet standards-based
Example of a disorganized storage cabinet , with teetering stacked bins and unprotected instruments .
Example of peel-packed loose instruments organized and stored vertically in dedicated bins
requirements and provide years of service . They must also be non-porous , so they can withstand routine cleaning with approved hospital disinfectants . Note : Storage solutions should not be comprised of wood , Masonite , cardboard or wood-based fiberboard-based product . If they are made of one or more of those materials , www . healthcarehygienemagazine . com • august 2023
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