As the staff of most Sterile Processing Departments (SPD) can tell you, sterilization is getting complicated. As surgeries become more and more intricate and advanced, so too does the surgical equipment that needs to be sterilized. This can be seen most clearly in the issues that SPD faces with loaner instrumentation.
Vendors may not always provide adequate amounts of sets for multiple surgical procedures within a facility, which can place a huge burden on the SPD and affect multiple areas. Staff may perform shortcuts in order to get sterilized sets back to the OR more quickly for multiple surgical procedures. Shortages may increase the use of Immediate Use Sterilization on sets that are not validated for it.
These and other issues can cause workflow and efficiency problems in the department, wasting the time of staff and costing the facility undue cost. More importantly, these issues can affect the effectiveness of sterilization and risk patient safety during and after surgery.
Using the 3 C’s in SPD: Communication, Collaboration, and Control
To combat common issues with loaner trays, Sterile Processing Departments should use the 3 C’s: Communication, Collaboration, and Control. The 3 C’s can be implemented, almost like a process to practically any SPD, and here’s how.
Communication is key to proper handling of loaner instrumentation. Without complete knowledge of how to clean and sterilize various sets of loaner instrumentation (many of which have very specific and detailed manufacturer instructions), staff will run into issues properly integrating these sets into their workflow. Consistent, clear, and thorough communication to all of the SPD staff (both verbally and written) is imperative to an effective sterilization process. Formal staff training is recommended, as well as communication media—such as signs and labels—throughout the workplace and on trays or containers to reinforce proper protocol.
Collaboration involves SPD working with all of the various departments that may handle loaner instrumentation to ensure that patients are always provided sterile instrumentation, and the workload for sterile processing is not made more difficult at other steps in the loaner’s journey through other areas of the hospital. Sterile Processing managers should communicate and over-communicate with OR leadership, physicians, vendors, and (in some cases) infection prevention to guarantee that all departments know what goes into sterilizing and maintain these sets, even outside of the SPD.
Control includes the implementation of clear and robust policy and procedure, regarding loaner instrumentation. This is arguably the most critical aspect of the proper handling of trays and kits and should be drafted as a document with the input of all the aforementioned departments. This document will help to enforce best practices for loaner instrumentation and keep all parties accountable for their roles and responsibilities throughout the sterilization process.
Loaner Instrumentation Process Improvements
By following the 3 C’s and trying to implement the processes associated with them, Sterile Processing departments take a huge step towards reducing the issues associated with loaner instrumentation. More than that, they make a huge improvement in the efficacy of their sterilization process and ensure the safety of all patients who rely on their instruments.
One simple and cost-effective companion to help implement the 3 C’s (particularly communication and collaboration) is with tags or labels that can be attached to many types of equipment that needs to be processed. These tags can be used to codify, identify, and date equipment, as well as attach notes about trays and scopes to anyone who might handle them throughout their trip through the hospital.
Whatever approach your organization decides to use to address continuous improvement, patient safety, efficiency, and compliance are the ultimate goals. With that in mind, every investment made to achieve those goals is worthwhile in improving the delivery of care.