Surgical instrument availability

AORN Journal,  May, 2005  by LuAnn Prephan

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a. true

b. false

9. To track instruments as they move through the facility,

a. bar code technology was implemented.

b. multicolored instrument tape was placed on instruments depending on service specialty.

c. radiopaque instruments tags were placed on all instruments.

10. After this three-year project, instrument availability improved from a preproject level of 64% to a postimplementation availability level of

a. 68%.

b. 78%.

c. 88%.

d. 98%.

[ILLUSTRATION OMITTED]

Table 1
FOCUS-PDCA Model (1)

* Find a process improvement opportunity.
* Organize a team that understands the process.
* Clarify current knowledge about the process.
* Uncover root causes of variations or poor outcomes.
* Start the plan, do, check, act (PDCA) process.

* Plan the improvement (ie, obtain approvals,
identify resources, develop an implementation
process, develop a communication plan, provide
training, determine evaluation plan).
* Do the improvement.
* Check the results (ie, evaluate process change,
identify outcome change).
* Act to hold the gain (ie, implement and consider
new process).

(1.) W E Deming, The New Economics: For Industry,
Government, Education, second ed (Cambridge, Mass:
Massachusetts Institute of Technology, 1994).

Table 2
FACETS Analysis (1)

Feasibility

Is the cost appropriate?
Is there enough equipment, materials, space, and time?
Are there enough people who are adequately trained?

Appropriateness

Is it ethical and legal?
Are the guiding principles aligned?
Does it fit the organization's mission, values, and vision?
Is the strategic plan aligned?

Consequences

Do the players upstream and downstream of the proposed
plan have authority to implement the plan?
What is the impact of implementing the plan?
How does the plan affect other areas of the system?

Efficiency

What is the result of a cost:benefit analysis?
Will there be a return on investment?

Effectiveness

Is the plan based on best practice?
Is the plan evidence based?

Training

Who needs to acquire what knowledge, skills, and attitudes
to make the improvement work?

Satisfaction

What is the anticipated customer response?
Will it meet the needs and expectations of internal and
external customers?

(1.) R Z Zechman, personal communication with the author,
Toledo, Ohio, 6 Nov 2000.

TABLE 3
Quality Assessment
Instrument Tracking Tool

Patient Identification
Sticker

1. Did you encounter problems obtaining instruments
before or during the procedure?
Y-- N--

2. If so, what was (were) the item(s)?--

3. Check box if applicable:
[] Was it listed on the preference card?
[] Was it unavailable?
[] Was it broken?
[] Was it mislabeled?
[] Was it located in the wrong area?
[] Was it in use in another location?
[] Other (please describe)-

4. Did this delay your start time?
Y-- N--
If so, by how long?--

5. Did this extend the procedure time? (must ask
surgeon) Y-- N-- If so, by
how long?--

6. Did the surgeon say that the equipment or
instrument delays caused an alteration in the
plan for the procedure? Y-- N--

7. If so, what changes were made?--

Surgeon's response
--

Comments
--