Where are the scissors? Oops, they may be in patient’s stomach
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EIHEIJI, Fukui Prefecture–Scalpels, scissors and other surgical instruments used in hospitals can be hard to keep track of, especially in those very rare cases when an item winds up in the stomach of a patient following an operation.
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That got the University of Fukui Hospital here thinking about developing a way to ensure that all instruments are not only accounted for, but sterilized after use.
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The system it came up with is primarily designed to prevent infection through the use of unsterilized or insufficiently sterilized instruments. Keeping track of the hospital inventory enables staff to prepare for surgery more efficiently and cut down on mistakes in the preparation process.
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It also enables the hospital to swiftly respond if an instrument is left in the body of a patient after surgery.
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Under the hospital’s comprehensive sterilization management system, two-dimensional codes were impressed on the 30,000 or so surgical tools used by the hospital so staff can determine where and when an instrument was last used and by who, and if it was sterilized after use.
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Hospital staff can access the information on dedicated smartphones.
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The technology was developed by the hospital and companies, both in Fukui Prefecture and elsewhere, and has been in place since 2014.
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The system has won three kinds of awards, one of which was given by the Ministry of Internal Affairs and Communications for advanced applications of information processing and communications technology. It also received another award in 2019 for improved nursing practices.
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The immediate payoff was improved safety and efficiency at the hospital, which quickly drew interest from other medical institutions.
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Other hospitals use a similar approach to keep track of inventory, but this is the first in Japan to follow the process from preparation for surgery to sterilization of all instruments after use.
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Previously, staff kept track of surgical instruments with written checklists, taking note of which instruments were requested for surgical procedures and whether they were returned. It was a laborious and somewhat nerve-wracking experience as some tools look very similar and are sometimes referred to by other names by doctors.
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The introduction of the system reduced the average time taken to collect and prepare instruments for surgery from 8 minutes to 4 and a half minutes. Operational errors dropped by about 93 percent.
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Staff members of hospitals around Japan have visited the Fukui hospital to learn more about how the system operates.
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“In hospitals, operations vary from department to department, so there are few cases in which we are able to review the entire process and streamline the way we do things,” said Yasuo Kokubo, 51, who is responsible for the sterilization of all instruments at the University of Fukui Hospital. “In that sense, things progress more slowly than in other industries. The system has definitely resulted in improved safety, so I hope word spreads about what we are doing.”
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