Despite the benefits of loaned devices , managing them can be difficult . Doing so effectively requires a partnership based on mutual trust and collaboration across all parties — Sterile Processing leadership , surgeons and other operating room ( OR ) staff , and those who are loaning the devices .” should be provided with the date of the surgery , physician , procedure , type of loaned devices and the quantity needed .
In many facilities , the OR contacts the purchasing department , which handles the purchase order for the loaned instruments or trays . Those requesting the loaned items should specify the quantity needs and the estimated time for use and return . Restocking requirements should also be communicated to prevent the need for immediate use steam sterilization ( IUSS ). Note : If devices arrive too late to process thoroughly , IUSS should never be an acceptable alternative . In such an event , the procedure should be rescheduled to ensure patient safety .
Documentation and communication are vital
Once loaned devices are received , the SPD is responsible for cleaning , decontaminating and sterilizing the items according to the IFU and facility policies and procedures . Loaned devices deserve the same focus and care as any other device being handled in the SPD .
All loaned instruments and trays received from an outside source ( vendor ) will be considered non-sterile , regardless of their condition upon arrival ( i . e ., wrapped , containerized ). Sets and items that appear ready for patient use could still harbor microorganisms that could pose a serious infection risk .
Loaned devices should be thoroughly inventoried and inspected in the presence of the vendor representative and documented accordingly ; both the vendor representative and facility representative in charge of logging in the loaned items should sign or initial the documentation to verify the contents received , and their condition upon receipt . Missing , broken or malfunctioning items should be noted to prevent the healthcare facility from being held responsible for the damage . Items inspection can include but not be limited to tips , box locks , ratchets , and cutting edges , and the quantity of implants ( screws and plates ) should also be verified at the time of receipt . Devices should also be free of stains , rust and retained bioburden . Containers , baskets , and trays should also be inspected to ensure they are in good working order and free of damage , and they should seal appropriately and not have stickers , tape or other sticky residue on their surfaces . Many facilities take photographs of the loaned items during the intake process . This prevents unexpected costs or vendor reimbursements for missing or damaged items .
Trays should also be weighed upon delivery to ensure the tray and its contents do not exceed 25 pounds , the maximum recommended by the Association for the Advancement of Medical Instrumentation . Again , all loaned instruments delivered to the SPD should include manufacturers ’ IFU for disassembly , cleaning , packaging and sterilization ( including the appropriate methods and cycles ). Loaned items should also include photographs of the product , provided by the vendor representative to help technicians reprocess unfamiliar items . If photographs are not on file with the organization , the vendor representative should be asked to provide them upon delivery . Any policy deviations or other
The OR , especially the service coordinators , plays an important part in the management of loaned instruments . They should be actively involved with the sterile processing department ( SPD ) to ensure that the devices arrive in time ( at least 24 hours before the procedure , but preferably 48 hours or longer ) to ensure adequate time to process and prepare them for the patient use .”
challenges related to loaned devices and sets must be addressed prior to acceptance of the items . Failure to do so will result in a case delay or cancellation . Upon completion of the surgical procedure , all loaned items are returned to the SPD for appropriate decontamination and high-level disinfection or sterilization according to manufacturer ’ s IFU . Once processed , the devices should be stored in a secure location until the designated time of pickup . In general , loaned items should be picked up within 24 hours ( but ideally no more than two business days ) post-procedure . The pick-up procedure should be communicated with the loaned device representative and should be documented and signed . A policy could state , for example , that any items not picked up within the designated time frame will be shipped to the company at their own expense . Designated pick-up times , such as 9 a . m . to 5 p . m . should be established , documented and enforced .
Upon pickup , the loaned items should again be inventoried and inspected . Discrepancies should be documented on intake paperwork and photographed , with acknowledgement from both the facility and company representatives . Both should also provide a final signature to notify the date and time of the pick-up .
David Taylor III , MSN , RN , CNOR , has served as a contributing author for the Healthcare Sterile Processing Association ( HSPA ) since 2019 . He is an independent hospital and ambulatory surgery center consultant and the principal of Resolute Advisory Group LLC , in San Antonio , Texas .
september 2024 • www . healthcarehygienemagazine . com •
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