Central Sterile Processing

In every hospital around the country, routine and emergency surgeries take place on a daily basis. Quite often, the coordination and appearance of the operating team, patient, and surgical supplies is seamless and uneventful. But sometimes surgeons can arrive only to find that necessary equipment and/or instruments are missing. This can result in a waste of valuable time and negatively impact the surgeon, surgical team, and even the tightly run surgical schedule. It sometimes results in a longer hospital stay for the patient. Surgical outcomes like these are preventable with the behind-the-scenes implementation of tools designed to identify and track medical supplies. With the help of color coding, asset tagging, and bar codes, surgical instruments can leave Central Sterile and arrive at the appropriate surgical suite on time and with peak efficiency.

The culture of a 21st-century hospital should include technological advances that can enhance departmental efficiency while continuously seeking ways to improve continuity of patient care. Communication between doctors and support medical staff is critical to comprehensive delivery of services. Patient safety must be systematically monitored and its outcomes measured. Risk prevention concerns top the list in most hospitals when it comes to preventing unnecessary contamination or failing to provide adequate medical care. When the latter is due to lack of departmental coordination or improper identification and organization of medical supplies and instruments, this deficiency must be mitigated.

The Biomedical Department of a hospital seeks to provide innovative yet cost- effective ways to integrate cutting-edge technology with continuity and intentionality in patient care. Its job is to assess the medical needs of the facility and then find solutions through research and consultation. It is perhaps the most critical area in the hospital because it must assume responsibility for services, supplies, and tech personnel. No other department has a greater need for a system of checks and balances with respect to its delivery of both goods and services.

The Biomedical and Central Sterile departments should be able to efficiently interface in order to provide necessary equipment for surgery. Technicians, surgeons and sterile supplies must all be coordinated in order to bring together resources and manpower for a specific patient who is scheduled for a designated surgical procedure. This process begins when biomedical staff does the research and then procures programs and tools to inventory, track, and ensure delivery of the exact surgical equipment and supplies needed at the time of a specific surgery.

The coordination that occurs between Biomedical and Central Sterile departments and designated surgeons does not happen because surgical staff posts the necessary information on a whiteboard at the nurse’s station. The coordination efforts needed to successfully treat one specific patient before, during, and after surgery depend upon procedures that go on largely behind the scenes. These procedures do everything from ensuring delivery of the right surgical instruments to the correct operating room, to successfully tracking supplies from the time they leave Central Sterile’s inventory until they arrive within the surgical field. This is best accomplished with color coding, appropriate asset tagging and bar codes.

In most medical facilities where surgeries are performed, the Biomedical and/or Central Sterile departments may be housed in distinctly separate parts of the hospital, making communication challenging. Technicians must rely on methods of labeling and tagging equipment to ensure that appropriate surgical instruments are autoclaved, bundled, and sent to the correct operating suite. Sterile surgical technicians must be able to stay ahead of the demand for surgical supplies so that surgeons do not arrive in their operating rooms only to find that surgical trays are incomplete or missing.

Many hospitals use a system of bar codes to scan instruments, drapes, and portable pieces of equipment into a master list of surgical supplies that becomes the inventory from which to draw upon as needed. As inventory is used to stock surgical trays or is assigned to a specific operating room, the same bar code may be scanned, designating that the items have been removed from stock and are in transport for a specific upcoming surgery and/or surgeon. Bar coding allows Central Sterile and Central Supply to keep an accurate accounting of inventory on hand and supplies that need to be ordered.

The Chief of Surgery or Faculty Surgeon often favors specific instruments and will have a standing request for their inclusion in his assigned surgical tray. Bar coding allows Central Sterile the specificity to assign instruments through computer scan, guaranteeing their availability at a moment’s notice, even for a specific user.

The use of bar codes is a quick and efficient way to track medical supplies and instruments as they travel to and from various departments, whether from Central Sterile to the operating room or from surgery to be washed, wrapped, and autoclaved for re-sterilization.

The efficacy of bar coding is dependent upon both electronic and computer functionality. In the event that either fails, color coding on asset tagging continues to ensure continuity and safety of procedures that govern communication between Biomedical and Central Sterile departments.

Asset tags are labels that are affixed to supplies and instruments to provide identification and tracking throughout the hospital setting. They may be constructed of paper, vinyl, or a synthetic material. A variety of top coatings can be applied to protect them from harmful effects associated with cleaning chemicals. Some are composed of a foil-type product that is available in silver and gold. Labels may be permanent or removable to meet the need for change-outs and relabeling due to track servicing. Tamper-evident tags are also available that shed when removal is attempted. Asset tags may be coded only by color and a numerical system or also equipped with a bar code for scanning and tracking. They are either directly applied to surgical drapes and larger pieces of equipment or affixed to the exteriors of opaque plastic that is used to wrap instruments before sterilizing.

Color coding on asset tags is often a less expensive alternative for smaller hospitals and outpatient surgical clinics for which software programs using bar codes are not cost effective. However, bar codes do provide superior tracking capability. A surgical nurse or medical technician anywhere in the hospital can locate a missing surgical tray or find a smaller piece of medical equipment by imputing the assigned bar code into the station’s computer.

Although labels may be one of the smallest items used in the daily operation of the Biomedical and Central Sterile departments in a hospital, they are of primary importance. Hospital management seeking to improve patient care, mitigate risk factors, and better coordinate activities between departments should consider implementing the use of color coding, asset tags, and bar codes.

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