Advances in technology and research have brought to life many surgical procedures that once seemed impossible. To keep pace, surgical instruments have evolved alongside medicine, making them more complex today than ever before.
This increasing complexity has many implications for sterile processing departments (SPDs), especially when it comes to instrument marking. Today’s instruments may come in many shapes and sizes, and some even have multiple detachable pieces that can be mixed and matched with other instruments. Many are also now being made with high-performing plastics instead of metals like stainless steel.
All of this begs the question: Where is surgical instrument marking headed next, and how can SPDs keep up? We sat down with Bill Camargo, CSCP, PMP, manager of marking services at Censis, to talk about current challenges in instrument marking and potential solutions on the horizon.
Today’s surgical instrument marking challenges
If anyone knows the biggest challenges that stem from surgical instrument marking, it’s Camargo. His daily responsibilities often include managing marking services simultaneously at six to 10 sites. He helps clients across the nation problem-solve their instrument marking challenges, and he has even led projects in Germany and Korea by conducting training over the phone.
“Instrument marking is important for helping facilities know which instruments were used in a specific procedure when they’re due for maintenance and the location of each instrument in their facility,” said Camargo. “It allows you to always know where instruments are, which is critical for getting the right instruments into sets.”
While instrument marking can be a challenge for both SPDs and instrument markers alike, it brings unparalleled benefits to health care facilities once it’s in use. And, luckily, common challenges can often be addressed. Depending on your facility’s specific challenges, possible solutions for effective instrument marking may include:
- A combination of different marking methods
- Marking instruments at your own pace
- Having a dedicated instrument marking project manager
- Commissioning your instruments into your existing surgical asset management system
Here are some of the biggest challenges Camargo identified that can be worked through.
Limited marking techniques
Censis uses two main types of instrument marking methods: Electrochemical marking and laser marking. Each has its own set of capabilities and limitations. And while neither can mark 100% of instruments, they can be used in combination to mark the widest variety of instrumentation, said Camargo.
“The biggest challenge is simply getting everything marked,” said Camargo. “To mark as many instruments as possible, you typically need to blend your capabilities.”
When electrochemical or laser marking won’t do the trick, Camargo typically recommends clients use tape or dots, which can be effective for a shorter period of time.
Marking plastic instruments
As the popularity of plastic surgical instruments increases, there is a need for better marking methods to follow suit. Electrochemical marking won’t work on plastic, and while laser marking does work, it needs to be adapted for each instrument based on the plastic’s polymers.
“If you do a bunch of tests, you can eventually find the right ‘recipe’ to mark a plastic instrument, but each instrument may need it’s own recipe” said Camargo. “Finding a way to mark plastic instruments universally or to more easily find out which polymers are in the plastic would be a good development.”
Surgical instrument tracking
As surgical instruments begin to arrive with multiple mix-and-match pieces, they are often still identified with a single catalog number. This makes it a challenge for facilities that track their instruments using catalog numbers to keep accurate tabs on each piece of the instrument.
A good example of an instrument where this challenge might arise is for Army-Navy retractors. The instrument is assigned a single catalog number even though it comes as a set of two – large and small.
Camargo’s team helps clients create modified catalog numbers to identify the two instruments separately. This is often done by adding “-1” and “-2” to the catalog number to distinguish each piece.
Fast-paced SPD environments
Sterile processing technicians are never short of things to do, and it can be a challenge to pull instruments out of their cycle for marking. One member of Camargo’s team typically plans to mark and commission 250-300 instruments per day, but small ambulatory surgery centers, for example, may only have an inventory of 5,000 instruments. This makes it harder for them to provide access to the instruments for marking than a large medical center that may have 120,000 instruments on hand.
Camargo and the marking team at Censis help with this problem by working closely with each site to optimize the number of instruments that can be marked per day without causing tray processing delays. The number of instruments marked at a time can be scaled up or down depending on a facility’s needs.
Tomorrow’s surgical instrument marking solutions
No one can predict the future, but educated guesses can be made. Here are a few surgical instrument marking advancements Camargo expects to see in the coming years.
Radio frequency identification (RFID)
RFID technology has gained a lot of traction in health care in recent years. It’s used to track medical devices, monitor temperatures in supply storage, and even track newborns to help prevent abductions. RFID is great for managing assets but hasn’t yet made much headway into tracking surgical instruments.
Using RFID in instrument marking would allow technicians to scan entire trays of instruments instead of scanning each instrument’s mark, which would significantly speed up the process. This would involve placing a transmitter on the instrument and using a receiver that can pick it up when scanning a tray.
While this is a known technology, Camargo said the advancement of RFID into surgical instrumentation would likely be a longer-term goal as opposed to an impending solution.
Increased focus on laser marking
The instrument marking industry is beginning to place greater emphasis on laser marking as the go-to method, and Camargo sees this technique only gaining more popularity. However, not all laser marking services are created equal.
“One of the big benefits of the equipment that Censis utilizes for its laser marking is autofocus,” said Camargo. “There’s a key element of laser marking that involves getting the focal length between the lens and the instrument surface correct. If it’s off in one direction, you either get a very light or non-readable mark, or you’re burning into the instrument. Marking an instrument using autofocus is a lot easier.”
Enhanced instrument marking and tracking systems
As Camargo noted, “There’s no point in marking an instrument unless it’s commissioned into your system.” Censis understands marking solutions are just the beginning for SPD automation, which is why Camargo’s team commissions all marked instruments into each facility’s instrument tracking system, such as CensiTrac, to give clients optimal visibility into their inventory. This allows them to track assets at the instrument level rather than simply tracking trays.
Censis also offers data optimization services to standardize vendors, catalog numbers and substitutes in a client’s system to improve instrument consistency and accuracy.
These technologies will only improve, so being an early adopter of marking services and tracking systems will help your SPD stay one step ahead. Learn more about Censis’ instrument marking solution, CensiMark, and how using instrument-level tracking in CensiTrac can make your life easier.