Instrument Count Sheet Policy

[Scarlette Sloan]

Anyone have a policy that covers accountability for the SPD Tech who fails to count the instruments correctly or forgets to date, initial or put an indicator in to the instrument pan or wrapped item? :confused:
Your input will be greatly appreciated :D

[lovemyjob]

I work in a small hospital but we have accountabilty. we must sign our sheets and the nurses send them back to de con so we know who did the sets and if there was anything missing before the room count. If you send all the sheets to the manager you can creat a graft and see where the ball is being dropped sometimes it is not the people but the process that needs to be changed. hope this helps.:)

[sonny1388]

I think making a graph would be a great idea. We do them for the nurses and their charting. If you make it the responsibility of the whole department, everyone is likely to make the necessary adjustments. If that doesn't solve the problem, some one on one coaching with the supervisor may be necessary, followed by disciplinary action if the non-compliance continues. The bottom line is, we work in healthcare, and one of the biggest aspects of that is documentation. You are not only covering your butt by complying, but also the facility's.

[JUNGLIISS]

I must agree with sonny but we must also get the O.R involve. they will send all the complains down to cspd when there is a problem but if you take a closer look you will see that a vast majority of the time they ( O.R tech / nurse ) will not take the time to check the count sheets and sign them. bottom line get both dept involve and remind them of the importance of useing the count sheet.

[Diane]

We just got the OR involved with accountablity. We initial our trays stating they are complete and correct, when they are opened and something is not right or missing they are to let Central Processing know after the case. If nothing is said then once the tray comes through decontam and on to assembly what ever is missing is then assumed that the OR staff is responsible. They use to say it wasn't in there to begin with but so far this is working. They have actually been very good about it.

[lariles]

We actually have policies in both SPD and OR for this topic. All cases have manditory opening counts to verify the completeness of the set (to hold SPD accountable ). The OR staff have to sign and record all counts on the sheets, they are returned to the SPD in de con, collected and counted for statistical data (to hold the OR staff accountable for doing the counts). All records with any error noted by the OR staff is documented and tallied each month to establish the accuracy rating for the department.
When I first took this department, everything was SPDs fault and they all thought that we did a horrible job. Since I have been able to show them concrete accuracy numbers which rebuts the "they always do that" mentality of the OR.
We now have a data base to work form for statistics and my staff are held to a performance standard based on these numbers. I have not been able to close the elusive black hoel for instruments coming up missing but have closed the gap..

[Angelique S.]

There will always be the tendency for most people to pass the buck. It is impossible to completely avoid "the other department is responsible" attitude. However, there are ways to compile data that may shift the single-minded focus on the CS department. We have a tracking system by TGX Medical called Alex Gold that has been particularly helpful with this problem. Furthermore, we have a position that is overseen by CS, yet resides in OR, called "Instrument Facilitator".

The instrument facilitator gets the sets and instruments direct from the OR suites. The facilitator looks at the set list through a lap top that carries our Alex Gold software. If there are instruments missing, the problem can be addressed immeadiately. The OR suite can be examined, the linens can be checked, etc. Technically, it can even be a double check for the ending instrument count to a certain extent.

Missing instruments are also addressed by the tracking system when we build the sets. The stickers that print out show what instruments are missing in the set. We also have an email system that tells the team leaders in OR if something is missing and needs to be reordered or searched for.

There is no perfect system. If there was, we all would have heard about it before. But, we're all trying. BTW, if someone comes up with a perfect system, please let me know. :)