Originally published in the October 1997 issue.
CS Must Control Surgical
Instrument Quality Measures
When it comes to maintaining the quality of a health care facility's
surgical instruments, the buck stops in central service--
literally and figuratively.
| "CS should be the gateway of
quality," Rick Shultz, Spectrum Surgical's president, told those attending the
International Association of Healthcare Central Service Material Management's annual
conference. "If I'm lying on a table, I want [instrument] problems to be found
in CS, not the operating room." |
Schultz spent nearly three hours on the final day of the conference
showing CS attendees how to properly manage the handling and repair of surgical
instruments, leaving them with a litany of useful tips to bring back to their facilities.
First and foremost, technicians need to become extremely familiar with the
instruments they're cleaning, decontaminating, sterilizing, and sending out for repairs.
They should know the functional names of the instruments (i.e., forcep, hemostat)
that designate their purpose, the proper names (i.e., Kelly, Crile) that reflect the
doctors who designed them, and after that knowledge becomes second nature, the slang terms
or nicknames (i.e., Johnny Bench retractor) that surgeons routinely give them, too.
Technicians should be able to discern the various shapes and sizes, the
difference between higher-grade German and lower-grade Pakistani-manufactured instruments,
whether instruments have stains or rust spots, and the appropriate solvents to soak them
in. It helps for them to learn how those instruments are used on the OR also.
Schultz advised CS managers to
collect instruments that may need repair work or even replacing, and show them to the
staff. "A lot of things that can go wrong with instruments are blamed on the
instrument company," Schultz said. Specifically, an instrument left to
soak in the wrong solvent may cause the instrument's material to break down.
"If you wan to destroy instruments, soak them in bleach, because
bleach eats into the stainless steel and creates holes." he warned. "We
don't wash our cars in salt water, so we shouldn't soak our instruments in saline either.
Saline is used to irrigate. Labor & Delivery may be using chlorahexidine
on instruments, which isn't compatible with stainless steel."
"CS should share this education with nurses because instrument
companies use these [practices] as loopholes to not fulfill warranties," he
continued. CS should thoroughly read the labels on the cleaning and soaking solvent
bottles for any specific instrument instructions, and to ensure material compatibility, he
advised. Instruments should be soaking as quickly as possible after a surgical
procedure, however. "Our enemy is dried blood," he said. "The
longer that blood is left on the instruments, the harder it is to get off."
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