Surgical reprocessing

1. Make sure central processing employees initial every tray they process. That way, if it was done wrong, you can find out who screwed up.
2. If things still do not improve, have 2 employees initial every tray. This will force them to double check every tray.

I'm sorry to say that any place there are intruments there are problems with instruments! I agree with Sandra about the accountability factor, having the CSS techs sign the sheets. Another thing- does your facility using intrument tracking software? There are various systems (my hospital uses SPM) and all the intruments trays are sets are barcoded so that they can be tracked. Now this has not totally eliminated issues, but it does help.
Another thing, if you have trays that are esecially problematic (one with a lot of specialty instruments, etc) it was helpful for our OR to have an OR person from that particular service to do a brief inservice for the CSS staff to go over the instruments and stress how important complete trays are to patient care. I think many CSS people don't really realize what an important role they play in patient care, for some people helping them to understand the importance of their role is a motivator.

Are the employees who build incomplete trays talked to?

Part of our CPD training is OR observation, and another week-long observation once a year as an 'inservice.' It never fails, that at least one time within the week, there's an incident where the indicator strip is missing, instruments are 'lost', etc. Which then gives the observer a look at why doing their job correctly is vital, and what happens when they don't. This helped tremendously.

We are a small OR 6 rooms, cysto and endolab. We do 20 - 30 cases a day. We work very closely with our CPD. We have 2 -3 contact people in the OR that CPD contacts about broken or missing instruments or any other issues. (As soon as an instument is missing, we are called so perhaps we can locate it.) When they get swamped, we go and help assemble trays, seal peel packs, wrap instruments etc. They initial each tray and mark with an orange tag any tray that is missing an instrument. One person in CPD is in charge of replacement and repair of instruments. If we have an instrument that is broken or not working correctly, we put it in a zip lock bag with a note to alert them to the problem.

The only time that we seem to have issues now is when there is new staff training both in the OR and