The amount of money spent on purchase of surgical instruments is extensive and for this reason there is a need to maximize the benefits that can be derived from these instruments. Surgical instruments are frequently lost or stolen from operating room, which causes huge financial losses to hospitals. In some cases the instruments may be left within patients’ bodies during a surgical procedure and hence get lost. Health care setups have to replenish this deficiency by purchasing more instruments, since a surgical unit of hospital is unable to function without availability of appropriate surgical instruments.
Surgical instruments pass through a cycle after procurement and this process continues till the end of their life. After procurement, the surgical instruments are assembled, packaged, sterilized, stored, distributed and then utilized during surgical procedures. After the surgical instruments have been used, they are scrubbed, autoclaved and then prepared for the next surgical procedure. Due to this repeated cycle, most surgical instruments are prone to getting lost and for this reason systems to track them during surgical cycle have been developed.
Although the concept of surgical instrument tracking is not new, more and more health care facilities are looking to utilize this approach to improve patient safety and to reduce the costs associated with purchasing new instruments. It is hoped that as inventory management improves and as surgical instrument traceability enhances, expenses related to procurement of new surgical instruments will decrease significantly.
Surgical instrument sets can be identified by using “ Bar Coding ”, which can be scanned before instruments are sent to sterile supply department and after they are received following sterilization. Alternatively, the Radio-frequency Identification (RFID) technology can be used that utilizes a miniature tag that contains a code containing relevant information about instruments. Another option is the use of digital photography coupled with related software to help in tracking instruments.
The use of Bar-coding in this scenario enables the working staff to determine whether a surgical instrument set is complete or not. Items that are absent can be ordered for replacement. In some cases, an automated procurement system is also in place, which allows automatic ordering of missing surgical instruments. An additional benefit is the ability of tracking systems to provide information about repairing and procurement costs of surgical instruments. To enhance quality of services, the reason-for-repairs and the expenses incurred on repairing are also provided by tracking softwares.
One good reason for tracking surgical instruments is their potential of spreading infections if they are not properly decontaminated. The presence of electronic tags on surgical instruments and electronic tag-readers in close vicinity can validate appropriate cleaning. Such tag-readers may be installed on instrument trays, in sterilization chambers and in some cases within the storage cabinets. This type of tag-reader placement can also facilitate in locating lost surgical instruments.
Some companies have developed instrument-tracking softwares that allow tracking of the use, inventory and location of surgical instruments at a given time. When the need for a particular surgical instrument arises, the system is capable of informing about its exact location. The facility of tracking instruments using serial number, surgeon’s name, procedure name or patient’s name is also available. This type of information is particularly important in neurosurgery since it allows quarantining of surgical instruments that are used in patients of Creutzfeldt-Jakob disease. Once the diagnosis of disease is confirmed, the fate of such instruments can be decided.
It is a matter of common observation that many surgical instruments that are routinely part surgical sets are almost never used during surgery. Consequently, they continue to add to the financial burden since they are decontaminated during every cycle. The use of tracking softwares allows optimization of surgical sets and allows removal of such instruments from these sets.
The efficiency of tracking systems depends upon the quality of data entered. Every time an instrument is moved, the related data is collected and the new location is recorded. The system then becomes capable of providing reports regarding the handling of surgical instruments. Such reports provide insight into patient safety measures that are in place in a health care setup. An additional benefit is the prevention of undue litigation, which may ensue if no proof to demonstrate optimum health care delivery is produced. E.g. if a patient develops an infection during the period following a surgery, surgical instrument tracking can provide information about how and when the surgical instruments were sent to sterile supply department and how they were decontaminated before return to operating room.