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Archive April 2020 XXI, No. 4

Do You Know Where Your Instruments Are?

Tracking software provides the data needed to improve clinical efficiencies and patient care.

Jon Kraft

Jon Kraft, BSN, RN, CNOR

BIO

IN AND OUTĀ 
Jon Kraft, BSN, RN, CNOR
TARGETED USEĀ  The team at Vanderbilt Children's Hospital can link individual instrument trays to specific patients and procedures.

How long would it take you to check the number of surgeries a tray of knee replacement instruments or laparoscopic tools were used in last week? Can you link them to specific cases or patients? There's no shortage of access to information in health care, yet some facilities lack the ability to track how often and where instrument trays were used. Our large hospital system is outfitted with instrument tracking software, which lets us pinpoint the location of individual instrument trays in seconds, capture accurate case cost information, improve the management of our instrument inventory and know for certain the specific cases they were used in and the individual patients they were used on. At least in theory.

Drilling down to the problem

We didn't realize our hospital wasn't realizing the full benefit of its instrument tracking technology until we had to trace an orthopedic drill back to the cases in which it was used. The instrument tracking software had the capability to provide that information, but our routine workflow prevented us from using it to increase efficiencies, improve the flow of instruments, as well as their maintenance and longevity, and improve the relationship between central sterile and the ORs.

To understand why staff didn't always engage our tracking software, you must first know how it's intended to work. Scheduled cases are loaded into the system the day before surgery. Members of the central sterile team pick needed instruments and supplies, and then load them onto individual case carts. A team member then scans individual instrument trays to link them to specific cases and patients, and scans the case cart to pair it and its contents with the OR in which it will be used. The next day, the scanned carts and instruments are delivered to ORs, where nurses need to scan only the carts to pair them to the cases they're working. If additional instrument trays are requested, a nurse would have to scan it to link it to the patient's unique barcode because the instruments weren't on the list of needed equipment.

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