Looking for instruments in the OR

[sandiegojames]

I was circulating a case the other day and the surgeon asked for an instrument we didn't have on the field or in the room, so of course the search was on... The surgical tech said he thought it lived in one of the sets but wasn't sure which one. So we ended up opening about three different instrument sets before finding the instrument needed, total pain.

1. Does anyone else ever have this problem? and 2. Anyone have a good method/procedure in their OR so it's easy to find anything you need?

[Rose_Queen, BSN, MSN, RN]

If we aren't sure what set something is in or if there aren't any peel packed on the shelf, we call the sterile processing department. They may have more peel packed upstairs or direct it to which exact set it's in to save us time. We also have triage levels for instruments, so they know if someone's on the table that takes priority over the case that won't start for half an hour.

[canesdukegirl, BSN, RN]

We have the instrument list wrapped onto one of the handles of each tray. This way, you can read the list to see what's in the tray instead of opening a tray unnecessarily.

[jdg0719]

This starts at the bottom, which in this case is SPD.

1. Whoever pulls the case should take into consideration regarding any special peel pack instruments that might be needed.

2. When the sets are being put together, SPD is responsible for inventoring the sets, and making sure each and every instrument is accounted for before the set is loaded in the autoclave.

3. If an instrument is missing, SPD should communicate the issue with a supervisor to take corrective measures, such as checking other sets that are "down", make arrangements in borrowing an instrument from different facility, informing the surgeon of any alternative instrument can be used.

Never good to be looking for instruments during a case. Not good for the patient. If its not a stat case, everything should be checked before the patient is brought into the OR.

[fracturenurse]

I call SPD or sometimes find somebody who scrubs those cases all the time.