On the right track

Keeping track of specialist medical equipment used in UK hospitals and medical centres represents a significant financial investment for any health trust.
And their availability, combined with the highest level of sterilisation and decontamination between each operation, can make a big difference to the effectiveness of any health trust and significantly reduce the risk of patient cross-contamination.

a business synergy

UK sterile services specialist Meditrax, which is part of the Altrax Group, is one company using its 27-year experience to build on providing integrated traceability and tracking systems to the healthcare market, through a synergistic partnership with Pryor Marking Technology – a designer and manufacturer of intelligent marking and code reading solutions.

Pryor has an established reputation for its marking expertise, which is supplemented by the latest vision technology from its subsidiary, Absolute Vision.

Nigel Bacon, managing director of Meditrax, said: ‘We had already developed an electronic barcode based tracking system, Traybax that could be used by hospitals to mark and track a tray of instruments.

‘This meant that hospitals knew which set of instruments had been used by which surgeon to perform which operation on which patient. When we spoke to Pryor, we realised that the company’s advanced laser marking techniques and code recognition systems would enable us to mark and trace individual instruments, not just the instrument trays.’

Currently, there is no legislation in the UK requiring hospitals or medical centres to provide this kind of instrument tracking but recently, the National Institute for Clinical Excellence (NICE) has issued guidelines for specific operations including invasive neuro surgery, spinal operations and tonsillectomies, where there is a specific risk from infection such as CJD. However, new guidelines in the form of a recent Health Technology Memorandum (HTM0101) are about to be introduced, which will cover tracking and traceability, as well as building regulations for sterile services departments and EN numbers for numerous elements including the labels if used for marking purposes.

Bacon says: ‘Despite the lack of legislation, the majority of UK health trusts are implementing more rigorous tracking and asset management systems wherever possible. The number of instruments involved is vast and represents a significant part of any trust’s annual budget. A typical 400-bed hospital may have between 150,000 – 200,000 tools in its medical instrument store.

‘The simplest operation may only require a tray with three or four tools, but the more complex procedures may require over 100. All of these need to be tracked and traced from the moment they leave the sterile store, through delivery to the operating theatre and the operating process, their subsequent return to sterile services, and then decontamination and sterilisation in preparation for their next utilisation.’

Central Sterile Service Departments (CSSD) can see the multiple benefits that a system like this can bring. These include better management of a hospital’s assets via a robust tracking system, whereby the history of each item used in a specific operation can be followed and recorded for future reference, should it be required. The system can alert sterilisation staff if certain instruments require specialist attention after they have been used a specific number of times. This can also help in the management of a rolling programme for replacement of instruments. In some instances, instruments may need to taken apart for full sterilisation, and the system can then display full instructions, either in written, photo or video format, to the trained staff for reassembly once the elements have left the autoclave.

making the mark

Once an organisation invests in a Meditrax system, their first task is to mark the instruments and this is where Pryor’s knowledge and expertise comes in to play. Health authorities can opt for either dot peen or laser marking and can either buy their own marking equipment or buy in a full marking service from Pryor.

For laser marking, Pryor recommends its HP20, a Yag Laser marker. One of the benefits of laser marking is that the instruments to be marked do not have to be fixed on to the marking machine, just placed in line of sight of the laser. This make the process faster than with the dot peen marking, which is achieved using Pryor’s new 3000 series machines, where each instrument has to be located firmly in place prior to marking.

The 2D Data Matrix marks use a recognised industry standard, GSI, which determines the format of data included in the code. The size of the mark may vary in size, dependent on the instrument, but the smallest are approximately 4mm². This enables a sterilisation operator to identify the mark with the human eye and then place the instrument on the specialist Witness Data Matrix code reader from Absolute Vision, which will then display the relevant information on a screen and update the records in the integrated Meditrax software system.

Some trusts are also in a position to sell their sterilisation services to outside organisations eg local dental practices or GPs surgeries, which can provide an additional source of income for the trust. Legislation is imminent that will require all dental practises to confirm with stringent standards for the reprocessing of medical devices. A lot of practices do not or will not have access to their own clean room, so outsourcing the sterilisation of their instruments will be their only option. Most importantly though for the patient is peace of mind that not only are the people caring for them of the highest calibre but that the tools being used are maintained and cleaned to the highest levels thus greatly reducing the chance of cross contamination.