Requisitioning and Handling Items in Healthcare

Requisitioning Items

• Requisitioning items must include sufficient notice for timely distribution.
• The requisition must be legible.
• The requisition must specifically identify the product.
• The requisition must specify the quantity requested.
• The requisition must specify the delivery location.
• The requisition must provide a means of documenting delivery and other desired data.

Handling Requisitioned Items

• Packages should be handled to preserve the function, cleanliness, and sterility of the contents.
• Items should be verified against the requisition, including the product number.
• The quantity requested should be specified based on the established units of issue listed on the requisition.
• The delivery location should be specified.
• Items should be inspected to ensure that they are complete, appropriately packaged and that the package integrity is not compromised.
• Hospital sterilized items should be verified for having undergone the sterilization process by examining the external chemical indicators.
• Expiration dates should be verified to ensure they have not passed.
• Items should be properly labeled in accordance with departmental standards.

Delivery Methods

• The most common means of transporting medical devices and other supplies is the "distribution cart."
• Dumbwaiters and dedicated elevators can also be used to transport items.
• Dedicated elevators are used to transport dirty pick-ups that go directly to decontamination and to deliver clean items from the sterile area.

Supply Distribution Systems

• Supply distribution systems should meet patient and user area needs.
• Systems should maintain the integrity of clean or sterile supplies.
• Systems should help maintain low inventory levels while meeting patient needs.
• Systems should use personnel efficiently and effectively control costs.
• Systems should ensure good inventory control.
• Systems should efficiently and effectively retrieve patient charges.

Pneumatic Tubes

• Pneumatic tubes, or "P" tubes can be used for delivering “STAT” supplies.

Most Common Distribution Systems Used in Healthcare Facilities

• Demand distribution
• Par level replenishment
• Exchange carts
• Case carts
• Specialty carts
• Just-in-Time (JIT) delivery

Policies and Procedures

• Correct handling of supplies requires policies and procedures to be made available.

Demand Distribution

• Demand distribution is used when a user requires few supplies or there is no automated patient charge system.
• It is based on direct patient charge requisitions or stock requisitions.
• The using department is responsible for maintaining the level of inventory.
• Users can use a computer to order supplies directly from SPD.
• It is a simple system. If no requisition is made, no supplies are issued.
• It is considered labor-intensive as SPD and storeroom personnel are interrupted to fill requisitions.

Demand Distribution "Piggy-Back Label"

• A label is removed from an item and placed on a patients charge card or bill.
• If a request is made by phone, SPD is responsible for activating the charge system in place at the facility.

Par Level

• A predetermined inventory list is prepared for each supply needed by the using department during a given time period.
• Inventory levels must be periodically reviewed based on historical data and changed to reflect actual use.
• Computerized locked supply systems are a variation of this system and can be referred to as vending machines or ATM's for supplies.

Centralized Exchange Carts

• Considered to be the most efficient system for close inventory control.
• Two identical carts are created, one left in the distribution area and the other placed in the using department.
• Carts are are restocked in the distribution area with items typically needed within 24 hours.
• Stocked carts are delivered to using departments.
• Used carts are brought back to the distribution area to be replenished and recycled when needed again.

Exchange Carts Disadvantages

• Duplicate inventories required.
• Expense of purchasing the carts.
• Additional space needed to store the carts.
• Time needed to distribute the carts.

Case Carts

• Used in specialty areas including operating rooms, cardiac catheterization labs, and labor & delivery departments.
• A list (case preference list) of required supplies must be developed for each surgical procedure.

Case Carts Types

• Closed case carts are more challenging to clean.
• Open case carts are easier to clean but provide no protection for items on the cart.
• Reusable covers for carts should be cleaned and disinfected after use.

Case Carts Requirements

• Good communication between SPD and the using department is essential.
• At the end of each procedure, the cart can be used to transport soiled instruments to the decontamination area but must be cleaned and sanitized before it is reused.
• The carts do not require sterilization.

Specialty / Procedure Carts

• Examples include code carts, dressing carts, respiratory carts, latex-free carts, dialysis carts, disaster carts, specialty catheter carts and isolation carts.

Specialty / Procedure Carts

• Similar to a case cart system, a specialty/procedure cart is used to distribute supplies for specific procedures or emergency situations.
• The carts are stored where they are readily accessible and can be immediately dispensed to the areas where they are needed.
• The system requires cooperation between using departments and SPD for the initial setup, ongoing monitoring, and updating inventory lists.

Just-In-Time

• Also known as “stockless” distribution systems (it is not truly stockless) but reduces storeroom inventory and does not totally eliminate it.
• A primary vendor or distributor directly supplies using departments with no storage needed.
• Eliminates the need for a distribution department.
• No inventory maintenance is needed.

Inventory Control and Management

• Computerized inventory management
• Total inventory control
• Perpetual inventory management
• Periodic inventory system

Total Inventory Control

• Responsibility of the materials management department.
• Refers to an efficiently organized, cost-effective process for maintaining optimum levels of inventory in the storeroom and in all user areas.
• Storeroom staff inventories each using department daily, including medical and surgical supplies, office supplies, forms, housekeeping products, and sterile procedure products.
• This system allows the best control of a facility’s supply inventory but is extremely labor-intensive.

Inventory Management Continued

Computerized Inventory Management

• Can store records or receipts and issues for faster processing of data.
• Calculates up-to-date information.
• Tracks the utilization of each item in inventory.
• Communicates data to the materials management system for direct reordering of the items.

Perpetual Inventory Management

• Known as "ongoing management of inventory," hence the word "perpetual."
• Each item is tracked individually.
• Is considered to be time-consuming, but important.
• An example is a "yearly physical inventory" where all items are counted and compared to information on hand.
• Another example is the "cycle count" where a small amount of inventory is counted on a given day.
• Less disruptive to daily operations.
• Provides an ongoing measure of inventory accuracy and procedure execution.
• Can be tailored to focus on items of higher value or higher movement (fast moving items).

Periodic Inventory System

• Inventory is checked at specific intervals between placing orders.
• If the quantity is below the base level, an order is placed.
• Sometimes classified according to the "A B C" system – based on dollar value & frequency of use.
• A: Items with a large dollar value – not used frequently.
• B: Items moderately priced and used relatively frequently.
• C: Items with a low dollar value.

Reorder Points (ROPs)

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

Minimums and Maximums

• Minimum is the smallest amount of stock on the shelf before an order is placed for replenishment.
• 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.
• They should also 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.

Computerized Systems in SPD Continued

• The quality of inventory and distribution can be assessed and improved by the following measures.
• Inventory
• Surgical case cart systems
• Surgical instruments & supplies to OR’s
• and other specialty departments

"Count Sheet"

• Is the most commonly used system in SPD.
• Count sheets are also known as “recipe cards” for surgical instrument sets.
• Typically reviewed by OR staff to verify accuracy.
• Data includes the correct name of the instrument, the manufacturer, catalog number, and descriptive information.

This quiz assesses your understanding of the protocols for requisitioning and handling items within a healthcare setting. Key areas include proper documentation, verification processes, and maintaining item integrity to ensure sterility and functionality. Test your knowledge on best practices for both requisitioning and handling to ensure optimal operational standards.