247 - Instrument Flow to and from Clinics and Central Sterile
Description: Clinical Issue There was no standard process for pick-up and delivery of dirty and clean instruments to and from clinics and CPD. This lack of a process led to miscommunications, inefficiencies and did not enhance interdepartmental relationships. Most important, we did not comply with regulatory requirements. Description of Team The team led by Ambulatory Services and Central Sterile met weekly to design and implement a regulatory-compliant process that meets the needs of all involved. The team was sponsored by the Associate Chief Nurse, Perioperative Services. Other departments represented and roles included on the team were Infection Control, Administrative Directors of Clinics and Support Services, and Healthcare Quality. Preparation and Planning We prepared a charter defining the problem, individuals needed to fix the issues, suggestions to get started and a target completion date. Our scope of work began with proper preparation of dirty instrumentation by clinics and extended through pick-up of reprocessed instruments by clinic staff or a courier. Work of this team would be done outside of our meetings. The meetings would be focused on strategy, reviewing status of action items, managing barriers to progress and determining next steps. Assessment We began work by mapping the problematic process and identifying opportunities for improvement. For example, some clinics were not keeping instruments moist until received by Central Sterile. Most importantly, we realized that we lacked a consistent reconciliation process to accurately determine which instruments were received in Central Sterile from clinics. As a result, clinics were sometimes dissatisfied when they maintained particular instruments were sent to Central Sterile but never returned. Implementation We developed a regulatory-compliant standard process for pick-up and delivery of dirty and clean instruments to and from clinics and CPD that worked well for clinics and providers such as Central Sterile and Support Services. Providing a foundation for the improved process, we developed and implemented a reconciliation process at the point of receipt of dirty instrumentation in Central Sterile. After acquiring specific needs from 60 clinics (such as their current transport providers and times and days that instrumentation must be picked-up and delivered) we made the appropriate changes, educated all involved and then launched the new improved process. Implications for Perioperative Nursing We helped assure safe patient care by enhancing sterility of instrumentation. Outcome We created a safe, standard, regulatory-compliant process for preparation, delivery, reconciliation and return of instrumentation to and from clinics and Central Sterile that meets the needs of our patients, the clinics and their providers such as Central Sterile and Support Services.
Co-Authors: Nancy Dwyer Doraiswami, Elena Canacari, Patrick Gordon, Sherry Calderon, Maria DePina, Deb McKinnon, Danelle Henry, Yoosly Noel-Cesar, Abderrahmane Beriane, Pierre R Fontin