Sojin Mappidecheri, Tom Brophy and Jonathan Reeves discuss the findings of an in-house quality assurance programme at Barts Health NHS. They highlight the importance of ensuring the correct sizing of surgical instruments and discuss the need to move to a standardised approach to measuring instrument dimensions, across the industry.
The quality of surgical instruments plays a pivotal role in ensuring patient safety, improving surgical outcomes, enhancing operational efficiency, and maintaining the reputation of healthcare institutions.
Since 2000, all new surgical instruments enter our in-house quality assurance (QA) programme within Barts Health NHS, prior to being accepted by the Trust. We test against BS 5194 (parts 2,3 and 4), as it plays a vital role in ensuring that surgical instruments are safe, reliable, and easy to manage. This directly supports the quality of patient care and operational efficiency. All instruments that fail the QA process are returned to the manufacturer or supplier, with replacements returned to the Trust, which re-enter the QA process.
Typical reasons for instruments failing the QA process include burrs, no traceability (no logo or trademark), fragments on serrations, scissors not cutting as defined in recommended standards. To date, ≈147k instruments have entered this process, with an overall failure rate of 5.8%. In the initial years of the setting up the QA programme, the instrument failure rate was 20%. However, over the duration of the programme, this has significantly improved and is currently 4.3% for 2024 (≈ 5000 instruments).
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