Rubak Peter, Christensen Ann-Eva, Granlie Mads, Bundgaard Karin
Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.
Unit for Psychiatric Research, North Denmark Region, Aalborg, Denmark.
Surg Open Sci. 2024 Oct 5;21:60-65. doi: 10.1016/j.sopen.2024.09.007. eCollection 2024 Sep.
This study presents the results of a surgical instrument tray optimization process implemented across all surgical specialties within the largest university hospital in Denmark.
Data was extracted from a comprehensive instrument optimization process including all Operating Rooms at Aarhus University Hospital. Adopting a holistic perspective, the optimization process, involved aligning instrument trays across various surgical specialties. This included: a) Reduction in number of instruments, b) Consolidation or separation of trays, c) Modularization - introducing modular trays for specific purposes, and d) Standardization - standardizing commonly used instruments across specialties. Instruments per tray, total number of instruments, and changes in the number of trays were compared against existing tray contents to identify discipline-specific changes.
Some specialties made substantial alterations to tray structures, while others primarily reduced number of instruments in existing trays. Across all specialties, optimization resulted in 17 % decrease in number of tray types ( = 0.01, 95%CI:1.0-6.8), 1 % increase in total number of trays ( = 0.36, 95%CI:-11.9-4.8), 18 % decrease in number of instruments per tray ( = 0.0002, 95%CI: 3.2-7.6) and 16 % reduction in total number of instruments for all specialties ( < 0.0001, 95%CI:404-758).
This study underscores complexity of instrument tray design. The approach employed at Aarhus University Hospital, involving interdisciplinary experts in an iterative design process, demonstrated the feasibility of redesigning instrument trays with significant reduction in content. Additionally, data suggests that reducing the number of instruments could lead to a decrease in workload within the Central Sterile Supply Specialty. This presents opportunity to minimize wasted resources and streamlining cleaning processes for unused instruments.
本研究展示了在丹麦最大的大学医院所有外科专业实施手术器械托盘优化过程的结果。
数据取自包括奥胡斯大学医院所有手术室的全面器械优化过程。从整体角度出发,优化过程涉及使不同外科专业的器械托盘保持一致。这包括:a)减少器械数量;b)合并或分离托盘;c)模块化——引入用于特定目的的模块化托盘;d)标准化——使各专业常用器械标准化。将每个托盘的器械数量、器械总数以及托盘数量的变化与现有托盘内容进行比较,以确定各学科的具体变化。
一些专业对托盘结构进行了重大改变,而其他专业主要是减少了现有托盘中的器械数量。在所有专业中,优化使托盘类型数量减少了17%(P = 0.01,95%CI:1.0 - 6.8),托盘总数增加了1%(P = 0.36,95%CI: - 11.9 - 4.8),每个托盘的器械数量减少了18%(P = 0.0002,95%CI:3.2 - 7.6),所有专业的器械总数减少了16%(P < 0.0001,95%CI:404 - 758)。
本研究强调了器械托盘设计的复杂性。奥胡斯大学医院采用的方法,即在迭代设计过程中让跨学科专家参与,证明了重新设计器械托盘并大幅减少其内容物的可行性。此外,数据表明减少器械数量可能会减少中央无菌供应专业的工作量。这为最大限度减少资源浪费和简化未使用器械的清洁流程提供了机会。