Q: “We use repair tags, and they do not work on all the variety of instruments we have, such as medical devices that do not have ring handles. What do you suggest?”
A:
From your question, it sounds like we are talking about medical devices such as curettes having round or flat handles without a place to clip a traditional repair tag that easily clips onto ring-handle-type instruments. I understand the need to identify (or tag) customer instruments returned to you (e.g., the operating room [OR] found instruments while being used during a procedure). Tagging helps ensure instruments will not appear again on the sterile field. They either need to be rejuvenated or see the scrap yard after inspection by a medical device reprocessing professional.
Back in the day, the OR staff would just tie a piece of suture around the medical device that needed some attention, and the staff would know that device had to be placed in the repair bin. Thus, the suture (as simple as it was) could be put on any device whether it had a ring handle or not.
But the question remains: what method is good to identify medical devices that need repair and do not have a ring handle for the traditional repair tag to be affixed to? The good news is that there are many options from various vendors.
One possible method I found is the use of cable ties. Staff can use these single-use, heat-resistant cable/instrument ties to affix on the devices identified as needing repair. Once the device is handed off the sterile field, then a cable tie is placed around it. Note that the tail part of the cable guide is not cut off because it “sticks out nicely” for the staff to notice when the device needing repair is returned. It can then be placed in the repair bin with the tie on after it has been decontaminated.
As always, I would make a policy on how to identify instruments so that if asked, you have all the correct documentation. Your policy can have a simple statement that states a red identifier (i.e., cable tie, repair tag, pre-printed tags [Fig. 1]) is used for any instrument in need of repair or further inspection for damage. Also, make sure your policy matches up with your various customers for consistency. Remember, whatever methods you use, make sure you have a policy in place that you and your staff can talk about. If not, then you do not have a policy.
Various guidelines/standards organizations offer support that many departments follow to help justify their practice. If you do not have these specific standards or guidelines, buy them for the complete wording and intent of them. Here are some statements you can use in your policy to support your practice of using various methods to “tag” devices from your customers that are damaged or in need of repair.
- ANSI/AAMI ST79:2017 (Section 6.3.5 Prevention of instrument damage) makes the following statement: “. . . have a process in place to identify instruments in need of repair/maintenance and removal from service (for example, a tag).”1
- ANSI/AAMI ST79:2017 (Section 7.5.2.1) states, “General operating instruments should be segregated from delicate items that require special handling, sharp items, and those identified for repair. Repair tags that are designed for surgical instrumentation should remain on the instrumentation throughout the cleaning process.”2
- [The] Association of Surgical Technologist (AST) in their AST:2018 Guidelines for Best Practices for Breaking Down the Sterile Field Section II, 4.C3a, states, “The surgery department should have a process in place for identifying instruments that need repair and removing from service to be sent out for repair, such as a pre-printed tag.”3
Final Note: Regardless of the type of tag or tie you use; I would suggest doing a few sample-run tests in your washer disinfector to make sure they do not melt. Save the data for your records.
References (APA Style 7th Edition):
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AAMI. (2017). ANSI/AAMI ST79:2017, Flexible and semi-rigid endoscope processing in health care facilities. (Section 6.3.5). Arlington, VA: Association for the Advancement of Medical Instrumentation.
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AAMI. (2017). ANSI/AAMI ST79:2017, Flexible and semi-rigid endoscope processing in health care facilities. (Section 7.5.2.1). Arlington, VA: Association for the Advancement of Medical Instrumentation.
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ST. (2008, October 20; Rev. 2018, June 1) AST:2018, Guidelines for Best Practices for Breaking Down the Sterile Field (Section II, 4.C3a). Littleton, CO: Association of Surgical Technologists.
Stephen M. Kovach
Stephen M Kovach, BS, CFER, started in the medical field in 1975 as a sterilization orderly and has worked in many positions within the Healthcare Industry. He presently is Clinical Educator Emeritus at Healthmark, A Getinge company.
