CS Must Control Surgical Instrument Quality Measures

Central Service Tips

1. If any instruments contains small cracks, don't immediately toss it in the trash.  Check with the manufacturer warranty.  "You can't afford to be throwing them out if they're under warranty," Schultz says.
2. If the instrument inventory runs low, check in laundry.  Typically, that's where towel clasps end up.  In fact, one facility found $1,400 worth of instruments left in the laundry bins.
3. Technicians can determine if a ratchet is out of alignment.   "Just hold the fingers rings together," he says.  "If the instrument is out of alignment, it will spring open.  You can test this by tapping it."
4. Tissue forceps will crack at their pressure point, or where the weld spot is.  Technicians can nest forceps for sterilization, but they shouldn't make the nest a foot long, to prevent tension build-up.
5. Tightening the screw holding the scissor blades together won't last unless technicians use a hammer and anvil, and pound the screw so it doesn't vibrate loose from usage.
6. When taping instruments, don't stretch the tape because it prevents the seal.  Schultz advises, "And keep in mind that when you wrap tape around five times, you've just created a five-story apartment for bacteria to hang out.
7. To figure out whether that blemish on the instrument surface is a stain or rust, use a pencil eraser.  If the area underneath the blemish is smooth and clean, it's a stain.  Either one results from improper cleaning, but can be remedied using different solvents.
8. Technicians may find that maintaining the quality of the needleholders is an uphill battle.  "Every needleholder you have is made to wear out just like a care tire," Schultz says.  "Not the rings, ratchets, box locks, or shanks, but the jaws that hold the needle.  Unlike tires, which cannot be retreaded, needleholders are made to be rejawed."  And that may happen mor often than not because surgeons may use needleholders for tasks other than what they were intended.
9. Scissors pose other challenges for Central Service.  A surgeon may complain that his or her scissor blades are dull.  The obvious solution?   "Do your customers a favor and find dull scissors before they're found in surgery," Schultz says.  Technicians can do that by learning how surgeons use scissors and which scissor types dull the fastest.  For the best results, look at how the distal tips are worn.
10. Central Service can obtain sheets of the "skin-like" material that repair companies use to test the sharpness of scissors, and keep some on hand for their own evaluations.

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