Background The 58 trauma compositions, including surgical instruments and sterilisable orthopaedic implants, are often sent incomplete to the central sterilisation (CS) concerning the implants. Sterilising incomplete compositions or keeping them at the CS until they are completed, leads to patient risks such as postponing or delaying surgery.
Purpose This study aimed at quantifying the incomplete compositions, the costs and suggestion of solutions with a multidisciplinary commission (MC).
Material and methods During 3 months, the sterilisation technicians (ST) counted how many times the compositions were sent incomplete. The costs were based on the surgical instrument number per composition, the checking complexity and the employee, water and electricity costs. Surgeon, nurse, pharmacist and STs reviewed the results and the existing implant resupply chain.
Results Eighty-four per cent of the orthopaedic compositions were sent incomplete. Either the nurse had forgotten to send the implants to the CS on time for 42% of them or the order had not yet been delivered. The delivery delay differed from 3 to 10 days. One-third of the compositions stayed more than a day at the CS before being completed. Sterilising incomplete composition cost €1156 for 3 months. The checking by ST could last 1 hour 30 min to make sure all the implants were present. The MC concluded to switch from sterilisable implants to sterile implants at an equivalent cost, and to substitute the biomedical service for the pharmacy to make order.
Conclusion With the pharmacy, the delay delivery shortened to 48 hour. The company provided the sterile devices freely, which were paid for when implanted. Misusing once-only use implants was avoided thanks to sterilisable patterns helping select the right implants. The removal of the incomplete composition sterilisation costs offset the sterile implant packaging elimination costs. The composition simplification saves time for the checking by the STs and makes the composition available quicker for the operating room (OR). Patient safety is improved thanks to a permanent and computerised implant traceability which also automatically makes an order once done. However, the switch implies a reorganisation in the OR’s storage facility.
This new optimised implant resupply chain ensures safety for the OR and the patients, and cost effectiveness for the hospital.
References and/or acknowledgements No conflict of interest.