SP professionals are typically not part of the stage where loaned instruments are requested , they must be involved in the arrangement as soon as possible to ensure the SPD has the proper equipment , supplies , instructions for use , etc . to ensure they can safely and effectively process the items prior to the procedure ( and within the timeframe stipulated in the policy ).
During his session , Berg explained it this way : “ If Dr . Smith is doing a total knee , for example , Company X will be bringing in a certain number of trays for the procedure , and we know that if the instruments are needed in the OR by Tuesday at 7 a . m ., we ’ ll need those total knee trays received in the SPD by Monday at 7 a . m . because our facility ’ s policy states instruments must arrive at least 24 hours before the procedure .” He went on to explain that if a drop-off occurs last-minute or at any point under 24 hours , the time of actual delivery ( as well as the reason for the late arrival ) should be documented . Such documentation helps identify trends and , perhaps , gaps in communications or compliance , which can be more proactively addressed – and surveyors will also be looking to ensure receipt of loaned instruments is documented and comparing that to the facility ’ s written policy . “ If you have a 24-hour or 48-hour policy on when loaned instruments need to arrive to your facility [ in advance of the procedure ], but surveyors discover that ’ s not being followed , you ’ ll be in violation of your own policy .” Don ’ t let loaned sets tip the scales .
4 Loaned instrument policies should also clearly address weight limits , which are reflected in the AAMI standards and Association of periOperative Registered Nurses ( AORN ) guidelines . Both recommend that instrument sets and trays prepared for sterilization not exceed 25 pounds , and that weight includes the container that holds the instruments . Berg recommends SP professionals not only state in the policy that 25-pound limit , but also working with vendors to determine how heavy sets can be brought down to a more manageable weight , perhaps by splitting the contents into two trays or working with the OR to determine if any instruments in the set that typically go unused can be removed from the tray and packaged separately .
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No IFU or vendor education ? No instrument acceptance . Without ready access to current instructions for use
( IFU ), SP professionals simply cannot properly and safely manage and process instruments . IFU and additional training requirements ( as needed ) should be directly stated in the loaned instrument policy , and they should then be reiterated with vendors . Ahead of all procedures where loaned devices are to be used , the SP team just also verify they have the proper equipment , supplies , IFU and other essential resources needed to reprocess those instruments safely and thoroughly . Not only should technicians understand the cycles needed to reprocess the loaned instruments , they must also have knowledge of how the devices are disassembled to facilitate proper cleaning .
“ IFU need to be provided for all instruments , no exceptions ,” Berg says . Once those instructions are provided by the vendor , copies must be made for SP professionals across all areas of the department , from decontamination and assembly to sterilization and storage . Inventory carefully – and take photos as proof . At any
6 point through the the use , handling or delivery cycle , loaned instruments can become lost or damaged , and that can prove costly for the user facility if diligent documentation isn ’ t happening at the point of instrument receipt and release . Berg said ensuring a manual or electronic count sheet is readily available at the location where loaned instruments arrive and leave the facility is crucial for tracking all set contents , and he stressed that list / count sheet should never be signed / approved without visual confirmation that all contents are not only in place and not damaged . Photographing set contents is a simple step that can pay big dividends .
“ Pictures are worth a thousand words ,” said Berg . “ If an instrument turns up missing or obviously damaged after it ’ s left your facility , imagine the benefit of being able to visually show they were present and undamaged at the time of pick-up .”
Julie E . Williamson is the director of communications / editor for IAHCSMM .
There are no easy answers or silver bullets , but having an understanding of why things happen the way they do in the loaned instrument world is critical , along with the understanding of how we as professionals can make it better , not only for the surgeons and patients but also for our staff ,”
www . healthcarehygienemagazine . com • january 2021
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