12 / 21
12
FDA between 2003 and 2006 that involved reprocessed SUDs, but
only 65 actually did involve a reprocessed SUD, and the adverse
events were comparable to events reported for new devices.
42
Guideline VII
Surgery departments should complete a comprehensive review of its OR kits and
surgeon preference cards as part of an OR kit reformulation program.
1.
Certain supplies are routinely placed in OR and anesthesia kits, such as custom
back table packs and patient skin preparation kits, and thrown away because they
are never used during a specific procedure or procedures.
27
This concept referred
to as “overage” is a significant source of RMW and drives up costs.
27
The surgery
department should review its OR kits to remove the excess supplies in order to
reduce RMW and costs.
21
A.
The review and streamlining of the custom kits should include standardizing
the number and types of each item in each kit which can result in decreased
inventory, reduced cost of the kits, and reduced amount of waste that
translates into lowering waste disposal fees.
B.
The review of the custom kits should involve the surgeons, CSTs, and RNs.
2.
Surgery departments should work closely with the surgeons and commercial
businesses that provide the kits to eliminate the unneeded, excess items that are
routinely disposed of as waste rather than being used during procedures.
32
A.
CSTs should work with the surgeons in reviewing preference cards to
identify unneeded or excess items, as well as identify items that are needed
in the OR during the procedure, but should not be opened unless requested
by the surgeon.
(1)
The surgery staff should audit the surgical procedures prior to
revising surgeon preference cards to identify items that are not
needed, items that should be in the OR unopened, and items that
were opened in excess (e.g., suture packets).
32
(2)
The review of the preference cards should focus on reducing and
standardizing the number and types of items needed for surgical
procedures.
(3)
Two recommendations the surgery department should consider is
to only list those items on the preference card that are used more
than 90% of the time and/or identify items used 50% or less of the
time and mark on the preference card as “hold”.
2
Guideline VIII
The surgery department should implement fluid management procedures to improve
the handling and disposal of liquid medical wastes.
1.
It is recommended that surgery departments decrease staff exposure to bloodborne
pathogens and minimize RMW disposal costs by installing fluid management
systems in the department.
32
An article published in 2004 by
Healthcare
Purchasing News
estimated that between 30% - 60% of HDO’s continue to have
surgical staff manually open the canisters and pour the contents down the drain.
6
Even though the canisters have been emptied of their contents the empty plastic