In our facility, because we do a lot of spine, implants are coming and going all the time, and we want to know what trays are being used. Not just "a spine tray," but "Tray X that was processed in Load Y on this date." Anybody should be able to pick up a tracking card and locate any instrument in our facility. We decided, as a team, on the most logical way to label the trays — a way that wouldn't slow down SPD, and that would make it easy for the nurses to see and record the information.
Tracking starts in SPD, where staff document tray name, load number and date. For the circulating nurse, there's a "surgical trays" section on every patient's post-procedure assessment/evaluation documentation. So, for example, in this section you might see "Manufacturer Brand #3," "Carpal Tunnel #3" and "Ortho Minor #2" trays next to stickers verifying the loads — Load #3 (processed April 13), #2 (April 8) and #5 (April 5), respectively — of those trays.
We can have up to 12 trays open at any given time, so the circulating nurse is the one documenting which trays are on the field and on which patients their contents are being used. After we raised our sterilization game, I started auditing the book of tracking logs, making sure I could open it and find out exactly where instruments were and how often they were rotating through.
I also started asking staff to find things on the fly. Using the last case of the day as an example, I'll ask the circulating nurse to find in the tracking log the load an implant came from, then I'll check the patient's chart to see that everything has been recorded correctly — or ask the operative nurse and check against the tracking log. The idea is to verify that everyone is consistently tracking correctly.