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Case Cart Systems. Presented by SPSmedical Largest sterilizer testing Lab in North America with over 50 sterilizers Develop and market sterility assurance.

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Presentation on theme: "Case Cart Systems. Presented by SPSmedical Largest sterilizer testing Lab in North America with over 50 sterilizers Develop and market sterility assurance."— Presentation transcript:

1 Case Cart Systems

2 Presented by SPSmedical Largest sterilizer testing Lab in North America with over 50 sterilizers Develop and market sterility assurance products that offer advanced technologies Provide full day sterilization Seminars and on-site Facility audits for compliance with best practices Corporate member: CSA and AAMI, serving on numerous sterilization working groups

3 Objectives At the end of this program, participants will be able to… create an OR and SPD committee to address case cart concerns write a plan for implementation of a case cart system collect data outlining your facilities specific needs as well as site visits to other facilities with a system already in place outline traffic patterns for this new system selection of proper case carts designs

4 Write a Plan Collect data Define the Benefits Define The Implementation Process How To Get The Most Out of Your Case Cart System

5 Establish A Joint CS and OR Case Cart Committee Take Minutes Provide Input Get Involved

6 Writing A Plan Keep it simple: Include the OR in the planning process Determine the when (time frame) Write down what you want to do Write down why you want to implement a Case Cart system Write down how you want to accomplish the task

7 Collecting Data Create a bench-marking tool View other facilities that have case carts (CS and OR) Inventory current instrument and tray inventories Inventory Operating Room supplies

8 Collecting Data (continued) Determine the number of surgical procedures a week, month and per year, Define your service areas: OR, Ambulatory Surgery, Endoscopy, OBS, or off-site locations Establish distribution polices & procedures

9 Site Visited: Number of Hospital Beds: Number of Patient days: Specialty Services: Numbers and types of sterilizers: (ask, do they have enough?) Steam ETO STERRAD STERIS System I Number of Case Carts: Regular carts: Specialty: Stand-by carts (in OR / CS): Number of cases per day, week, & year: Per day Per week Per year Number of FTEs (Full time employees): (ask do they have enough?) How many shifts: Supervisors: Lead Technicians: Technicians Service Areas: OR Ambulatory Surgery Endoscopy OBS ER Nursing Service ICU / SCU RT OT Other (Do you manage Portable Biomedical Equipment?) Benchmarking Tool

10 Defining the Benefits What will you get? Rapid turn-a-round time = $$$ (Operating Room Time) Improved Primary care for the Patient! Reduces Mechanical Nursing Inventory reduction – OR Product control Monitor returns Improving Infection Control Constant update of Surgeons Preference Cards

11 The Implementation Process Make sure you have measured your space. Define the cart route. Establish dedicated elevator/slide use. Establish communication devices between clean area in CS/SPD and clean area in OR and soiled area etc. Determine numbers and sizes of case carts based on service areas in the OR, i.e., Open Heart, Ortho Minor, Ortho Major, General Surgery or Minor Surgery, or GYN.

12 The Implementation Process Determine how many Stand-By emergency carts you will need. These will not be used everyday. Establish your inventory for the case carts. Initially there may be some duplication of products, this is normal, until the Operating Rooms confidence level is assured. Move instrument inventories to CS/SPD. Several weeks prior to the implementation, rotate OR Surgical Techs through CS/SPD to work with staff on assembling of the OR trays. Make sure you have tray listings complete and accurate.

13 Instrument Count Sheets Should accompany every tray however, they should not be placed inside wrapped trays or rigid containers AORN

14 The Implementation Process Design what a complete case cart looks like. Establish locations for every item that is placed on the case cart. No surprises for the OR will earn you their respect. Have policies and procedures written in advance on the ORs responsibilities in care and handling of instruments and basins. Develop a Case Cart Surgical Procedure form. A form used to communicate between the person who assembled the cart and the person that is utilizing the cart in the OR.

15 Case Cart Surgical Procedure Form General Hospital Case Cart Tracking Form Date:2/6/2009 Block/Room: 2Case:3 Time: Doctor:Dr. Socola DOW: Procedure: Lap Chole? Bunionectomy Preference Card Available?: Y / N If No Use: Special Instructions: Dr. Moore will do Bunionectomy Instrument Extras: Add Ortho Extras Name of Person who assembled Cart: Chuck CS Add these Supplies: OR Add these supplies: OR Feed Back: Cart Complete, Good Job!!! Attach to Each Case Cart 11:00 AM

16 Use the Form to Communicate Information between Departments: For OR: OR add aneurysm tray Needs 2 packages of hemostats For CS: Cart missing Basic Lap Pack Case Cart slips should be routed to CS/SPD Supervisor/Manager

17 The KEY To Success Is Commitment

18 Good Communication

19 These Are Your Customers

20 System Design Considerations ? ? ? ?

21 Functional Work Areas of A Sterile Processing Department Work Flow Pattern

22 Decontamination Washer / Decontaminators Pass-Thru Window

23 Decontamination Cart Washer Air

24 Enzymatic solutions, forced air & siphon Air Enzymatic Solution Brushes

25 Soiled Case Cart Bagged Trash Water Soak

26 Simplified Decontamination Area

27 Package, Preparation, & Sterilization Lockers Access to Bulk Stores SORTINGINSPSORTINGINSP

28 Sterile Storage/Clean Hold

29 Sterile Storage



32 Case Cart Holding

33 Simplified Case Cart System

34 More Complex System

35 Case Cart Designs Open Cart SystemClosed Cart System

36 Design considerations: Is cart easy to load and unload? Do the doors stay open during loading & unloading? Is the cart the right height and width? It has to fit through all doors. Is the handle well positioned? Do the carts move easily when fully loaded? Case Cart Design

37 Construction considerations: Locks and door handles should be flush to prevent doors from opening unexpectedly or catching on doorframes Stainless steel shelf edges should be smooth to prevent injury to people and product Make sure there are no metal barbs and that the welds are smooth on the inside and outside of the carts (Both open wire and closed carts) Case Cart Design

38 Other Considerations: Cart should be constructed of all stainless steel or plastic components Select a style with drawers to contain small items Know the terms of your warranty, carts wear rapidly if not maintained Make sure there are at least two breaking wheels Case Cart Design

39 Open Multi -Tier Cart Large Orthopedic Cases Laparoscopy Cart or Special Procedures cart Low Open Case Cart available with sides and back

40 Medium Upright Closed Cart Dont get them so large, no one can move them.. CART TIPS

41 Plan For Regular Preventative Maintenance Inventory Replacement Parts: Extra wheels Bumper guards Shelving clamps Doors Clean & Oil Wheels Regularly

42 Consider An Automated Cart Washer

43 We are obligated by the nature of our business and common sense to make the Case Cart Process & System as predictable as possible. Take the guess work out product locations. Take the guess work out of product descriptions. Start picking your cases a day in advance. Make each shift responsible for double and triple checking. All first and second cases must be complete by start time. The Complete Case Cart

44 Standardize Your Product Locations Put solutions on the bottom shelf in case of spillage. Place basins and larger like items on the bottom shelf. Place heavy trays, regular trays and containers on the middle or waist high shelf to reduce bending and lifting. (Reduces dragging also) Provide plastic washable bins for placement of small sterile items. Place the bin on the top shelf so you can see the contents. Place linens and surgical packs on the top shelf to facilitate checking and viewing of products.

45 Solutions Basins Trays Bin for Small items Packs/Drapes Linens

46 Automate Your System Computerized Supply Acquisition Computerized Materials Handling Computerized Case Cart System Surgical Supply System Equipment Management

47 Tracking Your Instruments

48 Computerized Case Cart Systems… Combine trays, kits, sets, equipment, pharmaceuticals, reusables and stock inventory into a single procedure case cart. The computerized system generates the necessary pick lists for each stocking area Records documentation for each cart and provides a case- completion function for charging patients for products used and returning unused items to inventory.

49 Case carts control the over-supplying of multiple procedure cases using predetermined preference card settings that identify which supplies are needed on a procedure-by-procedure basis, and which supplies are needed on a case basis. These procedures are also Physician specific. This avoids over supplying redundant items, such as sterile drapes, during multiple procedure cases. Case Carts…

50 Computerized systems help ensure: efficient scheduling of valuable, critical hospital equipment by providing conflict reports, which can include any needed clean-up/sterilization time. For equipment that is needed at multiple facilities, a system provides the ability to share the equipment, check conflicts across facilities, and account for transportation time. Equipment Conflicts

51 Tray & Equipment Locator Maintains the locations of all of your trays in… REAL TIME! By utilizing Bar Code labels & scanners, you can locate and communicate the location of most all your trays and equipment immediately. Productivity Measurement Tool

52 Surgeons Preference Cards Requisitions and Pick Lists

53 Surgeon's Preference Card Service: Plastic Surgery Orthopedic Surgery General Surgery Surgeon: ______________________________________________________________ Glove Size: ____________________________________________________________ Procedure(s): __________________________________________________________ Position: ______________________________________________________________ Prep: _________________________________________________________________ Supplies: ______________________________________________________________ ______________________________________________________________________ Instruments: ___________________________________________________________ ______________________________________________________________________ Suture: (include needle sizes) _____________________________________________ ______________________________________________________________________ Medications/Irrigations: ___________________________________________________ ______________________________________________________________________ Dressings: _____________________________________________________________ Equipment: ____________________________________________________________ ______________________________________________________________________ Special Preference(s): ____________________________________________________

54 The Surgery preference card function makes it easy to: create generic and physician-specific cards for all types of procedures. promote standardization across physicians and across multiple facilities Lost Preference Cards

55 CASE CART REQUISITION Patient:______________________ Procedure Date: 02/02/2002 Surgeon: LAZIO, HAWKEYEProcedure Date: 02/02/2002Case #: nd Surgeon:Start Time: 0800Room: 25 Patient: SMITH, JOHNRadio Station:WLUVGloves: 8 reg MR #: 45367Room Temp: 68F Date of Birth: 10/05/50 Age: 39Sex: M PROCEDURE(S): INSERTION PACEMAKER TRANSVENOUS; Location:Comments: From Card: Hospital Pacemaker Implant PREP: Betadine Sol.Comments: Preps before scrubbing POSITION: SupineComments: DRAPES: Drape Sheet, Towels X 4 INSTRUCTIONS:MEDICATIONS 0.5% Lidocaine plain in 10cc syringe with 25ga 1 ½ needle 1 ea NACL 1000cc COMMENTS: Have image available Crash Cart in room no Bovie or suction (have available in room) Does not like 4X8s, likes lap sponges He will prep, inject, then scrub Suture on pacemaker cart 18 ga Spinal Needle BD # Pink tip X 2) CORDIS AVANTI # **5FR FEM-ARTERIAL LINE INTRODUCER (available) *********************FOR RE-DOS ADD CULTURE TUBE*************************** ADDITIONAL NEEDS: DESCRIPTI ON INITIALS DESCRIPTION INITIALS: ______________________ _________ ________________________ _________ PICKED LOC CODE CDM REF # ITEMQTY HLD QTY COST Drape CSD L32374 BASIC PACK SET-UP CSD N 6615 DRAPE C-ARM

56 What Does The Future Hold? Case Cart Locators – Tiny micro chips that indicate every case cart location within a facility. Instrument Tray Locators – Tiny heat resistant micro chips that indicate the location of trays no matter where they are, all in real time. When picking supplies for a surgical procedure, once the surgeons preference card is selected, tiny green lights indicate which products to select off the shelf. When products are removed from the shelf, scanners automatically relieve inventory, reorder, and charge the specific patient. Optical lithograph printers print package and tray contents by passing through a conveyor.

57 ! THANK YOU! SPS medical Supply Corp. Sterilization Products & Services 6789 W. Henrietta Road Rush, NY USA Fax: (585) Ph: (800) Website: © SPSmedical Supply Corp. Certificate is available after viewing by calling SPSmedical or ing Case Cart Systems

58 Purchasing AAMI Standards If your organization is not a member of AAMI, you may purchase the Standards directly from SPSmedical at our member discount. The member discount saves you 40-50% depending on the document. For example: ORDER CODE: AAMI ST:79 List Price: $220 Member Price: $110

59 References & Resources Association for the Advancement of Medical Instrumentation 1110 North Glebe Road, Suite 220, Arlington, VA Fax: Association of periOperative Registered Nurses 2170 South Parker Road, Suite 300 Denver, CO Canadian Standards Association 5060 Spectrum Way Mississauga, Ontario L4W 5N6 CANADA Fax: (416) Certification Board for Sterile Processing & Distribution 2 Industrial Park, Suite 3 Alpha, NJ International Assoc. of Healthcare Central Service Materiel Management 213 W. Institute Place, Suite 307 Chicago, IL Fax:

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