Requisitioning and Handling Items in Healthcare

Requisitioning Items

• Requisitions must be legible
• Requisitions must identify the product
• Requisitions must specify the quantity requested
• Requisitions must specify the delivery location
• Requisitions must provide a method for documenting delivery

Techniques In Selection and Handling of Requisitioned Items

• Handling packages to preserve the function, cleanliness, and sterility of the contents
• Verifying the item selected against the requisition including the product number
• Specifying the quantity requested, based on established units of issue selected against the requisition (e.g., box, case, each)
• Specifying where the items are to be delivered
• Inspecting the item to ensure that it is complete and appropriately packaged and that the package integrity is not compromised
• Verifying, for hospital-sterilized items, that the item was subjected to the sterilization process (by examining external chemical indicators)
• Verifying, when appropriate, that the expiration date has not been exceeded
• Verifying that the item is properly labeled departmental standards

Delivery Methods

• The most common means of medical devices and other supplies is the distribution cart
• Just-In-Time distribution is known as stockless systems and reduces storeroom inventory
• Just-in-Time distribution systems eliminate distribution departments and inventory maintenance

Inventory Control and Management

• Total inventory control refers to a cost-effective process for maintaining optimum levels of inventory in the storeroom and all user areas
• Total inventory control requires daily inventories of each using department, including medical & surgical supplies, office supplies, forms, housekeeping products, and sterile procedure products
• Total inventory control provides the best control of a facility’s supply inventory but is extremely labor-intensive
• Computerized Inventory Management
  • Stores records of receipts and issues for faster processing of data
  • Calculates up-to-date information
  • Tracks utilization of each item in the inventory
  • Communicates data to the materials management system for direct reordering of items
• Perpetual Inventory Management
  • Is known as “ongoing management of inventory”
  • Each item is tracked individually
  • Is considered to be time-consuming but important
  • Is commonly done using an annual physical inventory where all items are counted and compared to the information on hand
  • Can also be done using a cycle count where a small amount of inventory is counted on a given day
  • Cycle counts are less disruptive to daily operations and provide ongoing measures of inventory accuracy and procedure execution
• Periodic Inventory System
  • Checks inventory at a specific interval between placing orders
  • If the quantity is below the base level an orders is placed
  • Is sometimes classified according to the “A, B, C” system based on dollar value and frequency of use:
    • A: Items with a large dollar value and not used frequently
    • B: Items moderately priced and relatively frequently used
    • C: Items with a low dollar value

Reorder Points

• Lowest quantity of an item that can be on hand before it is reordered.

Minimums and Maximums

• The minimum is the smallest amount of stock on the shelf before an order is placed for replenishment
• The maximum is the largest amount of an item that should be in stock at any one time

Economical Order Quantity (EOQ)

• The optimum quantity of an item to order
• Based on historical data, this helps to prevent over ordering

Computerized Systems in SPD

• Inventory and distribution practices should be consistent throughout the healthcare facility
• Inventory and distribution practices should be verified by an initial quality audit and by ongoing monitoring and documentation, with appropriate corrective actions taken when needed
• All services in SPD mandate computerization of the various processes to enhance data management and provide detailed management reports.

Tracking Systems

• Used for tracking:
• Instrument sets
• Loaner instruments
• Specialty devices
• Surgical case carts
• Employee productivity
• Equipment and instrument utilization
• Specific processing information
• Preventive maintenance of instruments

Count Sheets

• Are also known as recipe cards for surgical instrument sets
• Are typically reviewed by OR staff to verify accuracy
• Include:
• Correct name of instrument
• The manufacturer
• Catalog number
• Descriptive information

Summary

• Inventory of medical and surgical supplies can represent up to 40% of a facility’s operating budget
• Inventory must be managed to reduce costs and increase efficiency
• Computers and good, sound information systems provide the tools needed to be better, more prudent, successful managers.
• Inventory performance is evaluated by:
• Inventory turnover
• Percent of back orders
• Availability of critical items

Sample Questions

Sterile Storage, Inventory Management and Distribution

1. In which distribution system are requisitions filled and delivered as they are received?
   a.Specialty cart b.Case cart c.Par level d.Demand

2. Sterility maintenance covers should be placed on sterile items… a.as soon as the items come out of the sterilizer b.after the items have been aerated c.the day after the items have been sterilized d.when the sterilized items cool to ambient room temperature

3. Which of the following statements is the primary reason that items are allowed to cool on sterilizer cart before being placed in storage? a.Items removed too quickly may be hot enough to burn the technician.
   b.Condensation and contamination may result if items are moved to cooler areas when they are still warm. c.The packaging material may be damaged if packages are moved when they are still warm. d.Tape seals may come loose if packages are moved when they are warm.

4. Which of the following BEST describes the general environmental conditions of SPD sterile storage? a.Controlled temperature and humidity, limited traffic b.Controlled temperature and high humidity, limited traffic
   c.High temperature and high humidity, no traffic restrictions d.Controlled temperature and humidity, no traffic restrictions

5. Outside shipping cartons should NOT be brought into the SPD because they are often… a.extremely heavy b.lint producers c.biologically contaminated d.water repellent

6. Which of the following is the MOST important factor in preventing bacteria from contaminating sterile packages? a.The sterilization method used
   b.the quantity of packages c.The handling of packages d.The correct use of sterility maintenance covers

7. When transporting sterile packaged items by hand… a.Place them in a plastic bag. b.Stack them on top of one another. c.Cradle them in your arms. d.Place a linen wrapper over them.

8. "Inventory performance" (a rough indication of the effectiveness of the inventory system) is evaluated by all of the following EXCEPT… a. inventory turnover b. percent of back orders c. availability of critical items d. departmental preference

9. Which of the following is the MOST efficient and cost-effective method for inventory control in the SPD ordering and data generation? a. Computerized Inventory Control System b. Exchange-Cart Distribution System c. Par-Level Restocking Distribution System d. Stockless/Just-in-Time Distribution System

10. Before releasing an item to fill a sterile supply order, all of the following must be checked EXCEPT… a. the expiration date b. cost effectiveness data c. whether the package is damaged d. verification of chemical indicator

This quiz covers essential procedures for requisitioning and handling items within a healthcare setting. It focuses on the requirements for legible requisitions, verification of selected items, and techniques to ensure cleanliness and sterility during handling. Test your knowledge of the proper documentation and inspection processes for medical requisitions.