Approaches to the rationalization of surgical instrument trays: scoping review and research agenda

Abstract

Background Surgical Tray Rationalization (STR) consists of a systematic reduction in the number of surgical instruments to perform specific procedures without compromising patient safety while reducing losses in the sterilization and assembly of trays. STR is one example of initiatives to improve process performance that have been widely reported in industrial settings but only recently have gained popularity in healthcare organizations. Methods We conduct a scoping review of the literature to identify and map available evidence on surgical tray management. Five methodological stages are implemented and reported; they are: identifying research questions, identifying relevant studies, study selection, charting the data, and collating, summarizing and reporting the results. Results We reviewed forty-eight articles on STR, which were grouped according to their main proposed approaches: expert analysis, lean practices, and mathematical programming. We identify the most frequently used techniques within each approach and point to their potential contributions to operational and economic dimensions of STR. We also consolidate our findings, proposing a roadmap to STR with four generic steps (prepare, rationalize, implement, and consolidate) and recommended associated techniques. Conclusions To the best of our knowledge, ours is the first study that reviews and systematizes the existing literature on the subject of STR. Our study closes with the proposition of future research directions, which are presented as nine research questions associated with the four generic steps proposed in the STR roadmap.

The Perception of Nursing Professionals Working in a Central Sterile Supplies Department regarding Health Conditions, Workload, Ergonomic Risks, and Functional Readaptation

“…It is noticeable that the role of health professionals in the CSSD goes beyond routine and repetitive work, requiring specific training for qualification in the development of specific skills to work in this sector [ 11 ]. This finding is in agreement with the study by Santos et al, which points out that the elimination of unnecessary or redundant instruments in surgical trays can save time, require less operational effort, and bring lower costs to the CSSD, without compromising the surgical procedure and the health of patients [ 24 ]. Therefore, simplifying surgical instruments can also significantly reduce sterilization time, decrease ergonomic risks, and lower instrument acquisition costs.…”

Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review

“…The first one applies RFID (radio-frequency identification) for surgical instruments to control the quality of surgical tray assembly and instrument traceability. Trays with missing instruments are a recurrent problem in surgical theaters [ 175 ]; an LH project to adopt electronic Poka–Yokes (mistake proofing) at the final stage of tray assembly would help to address the problem. The second one uses biomedical sensors connected to the IoT to track inward patients’ vital signals, activate rapid-response teams, and reduce the time to assist patients in critical condition.…”

Optimisation of perioperative procedural factors to reduce the risk of surgical site infection in patients undergoing surgery: a systematic review

“…Four literature reviews relevant to the scope of the current work were identified (Table 1 ). In particular, Dos Santos and colleagues [ 6 ] sought to understand the main techniques and approaches in the rationalising of surgical sets, the impact on financial and operational performance, and the knowledge gaps towards which research should be directed. The review identified many studies reporting signs of improved performance both operationally , concerning set assembly, OR management and ergonomics, and efficiently in terms of washing and sterilisation processes, repair, purchasing, set-up and professional education.…”