Over the past several decades technological advancements have changed the face of surgery , and healthcare organizations have been forced to keep pace with those changes . One way for them to do so without adding significant costs to their bottom line is through a focused , comprehensive and effectively implemented loaned instrument program .” provided . Ideally , the manufacturer should provide a series of illustrations or photographs that align with the inventory list and corresponding product lot number . Those who validate and provide quality checks create robust processes that protect the organization financially . It is highly recommended that the SPD catalog and photograph every loaned item during receipt at the facility and release back to the vendor .
It is important for organizations to ensure that the loaned instruments they receive are complete and in good working order . Taking an inventory of the contents and cataloging each item keeps the process in check for both the vendor and the organization . Items in the set may be vital to the procedure ; therefore , any missing , damaged or inoperable items could compromise patient care . Additionally , failure to inventory and document loaned items could needlessly cost the healthcare organization dearly if an item isn ’ t accounted for accurately .
Throughout this process , SP technicians assigned to intake ( receipt ) of loaned instruments should verify that the instruments are in good condition and free from discoloration , rust or pitting . If devices have been dipped or instrument taped , technicians must ensure that it has been applied correctly and is not damaged in any way . If an instrument is in poor condition , the issue must be documented clearly , and the vendor representative should replace it immediately .
Because loaned instrumentation may also travel frequently from one hospital to another , it is vital that the SP team inspects condition of the containers , baskets and trays , ensuring there are no dents , cracks or other signs of damage . It is essential to ensure that the lids fit securely , the seals are intact , and there is no rusting or sticky residue . Additionally , technicians must ensure that the locking mechanisms are functional , the valves or filter mechanisms are present and in working order , handles are intact and undamaged . Any issues identified should be reported to the company representative before accepting the loaned devices . Doing so will help prevent the facility from being billed for previous damage .
Power of labeling , weighing , communicating
Properly labeling and numbering trays with the requesting surgeon , procedure and patient allows the SPD and OR to keep track of loaned sets — keeping them together , organized and ready for use . If a procedure requires loaned sets from multiple manufactures , it will be necessary to label appropriately to ensure instruments are not mixed or combined .
All instrument sets , regardless of who owns them , should not exceed 25 pounds ( this weight includes the container ), according to ANSI / AAMI ST79 . Heavier instrument sets may compromise the sterilization process , rendering instrument sets unsafe for use . In addition , sets exceeding 25 pounds may pose an ergonomic injury for employees .
LOANED INSTRUMENTATION CHALLENGES
Ineffective loaned instrument and implant management , including last-minute arrivals and the failure to obtain manufacturers ’ instructions for use , can result in a host of problems for sterile processing and operating room personnel , including :
● A lack of processing time , which can lead to inadequate processing
● No IFU to guide the process ( cleaning , decontamination , assembly , packaging , sterilization )
● Insufficient processing staff to manage workload
● Inability to process loaned sets due to the lack of training to work with complex medical devices
● Missing information to correctly label , identify or correlate with the patient or procedure
For effective instrumentation management , open communication is always advised , and this is certainly important with loaned devices and when coordinating between multiple parties ( e . g ., surgeon , OR , vendor and SP ) must occur . For example , for the SPD to be able to plan for the scope of work for which they will be responsible , it is important to know which loaned instrumentation is needed ( the manufacture involved ); the scheduled surgical procedure ; patient ; scheduled arrival time for the instrumentation ; whether the instrumentation is consigned to the facility or will be arriving via a representative of the company or its courier ; the number of instrument sets required for that particular procedure ; and whether the manufacturer ’ s IFU are available and accompanying the instruments ’ arrival . Knowing this information in advance allows the SPD to plan accordingly . Planning may include but not be limited to increasing staffing to accommodate additional workload , training or in-servicing of staff ( across all stakeholder departments ) and ensuring IFU are provided and followed correctly .
Many factors must be considered when managing loaned medical devices , and thoughtful , comprehensive processes must be adopted and implemented to ensure timely use and safe , thorough processing . When all stakeholders agree to the policy , this prevents practice deviation and helps ensure that everyone involved has equal input and accountability .
David Taylor III , MSN , RN , CNOR , is an independent hospital and ambulatory surgery center consultant and the principal of Resolute Advisory Group LLC , in San Antonio , Texas . He has served as a contributing author for the Healthcare Sterile Processing Association ( HSPA ) since 2019 .
30 july 2023 • www . healthcarehygienemagazine . com