Surgical Instrument Management in Sterile Processing

Study Notes

Missing instruments are a common challenge in Sterile Processing Departments (SPDs), causing delays and frustration in surgical suites.
Missing instruments can halt surgical cases, and OR circulators and SPD runners may spend 15 minutes or more searching for critical instruments.

Accurate count sheets are essential for preventing missing instruments, ensuring that SPD technicians can assemble trays quickly and accurately.
Count sheets must include critical information, such as manufacturer, catalog numbers, instrument descriptions, and quantity.
Inaccurate count sheets can lead to the wrong instruments in trays, no information to order replacement instruments, and failure to follow manufacturer's instructions for use.

Instruments mixed between sets, prioritization systems that leave critical instruments behind, and bad data on critical tray count sheets.
No replenishment system to replace damaged instruments.
Lack of organization and standardization in instrument storage and retrieval.

Implementing an effective replenishment system to replace missing and nonrepairable instruments.
Using a standard nomenclature for instrument names, including instrument type, inventor or scientific name, description of direction/curvature, length, and thickness (if applicable).
Organizing instrument storage using the 5S technique, which includes sorting, setting in order, shining, standardizing, and sustaining.

Sort: Remove unnecessary instruments, and categorize instruments into needed and not needed groups.
Set in order: Organize instruments to promote workflow, placing high-use instruments in easy-to-reach locations.
Shine: Clean and maintain the instrument storage area, ensuring it is neat and tidy.
Standardize: Use visual indicators, such as Kanban cards, to signal when an action is needed, and standardize the backup wall inventory.
Sustain: Develop a system to ensure the organization and replenishment of the backup wall stays in place.

Focus on processes that can be controlled by SP technicians, such as flow through decontamination and assembly.
Implementing a system to keep trays from the same case cart together through decontamination and assembly.
Using tags validated for decontamination processes to keep trays together.
Employee engagement and buy-in are essential for success in improving the flow of instruments in an SPD.