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Managing Missing Instruments In Sterile Processing

Updated: Apr 4

Surgical instrument sets with missing instruments can create delays in the OR, and in worse case scenarios, they can cause a surgeon to change their approach to the surgery and patient care.

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Evolved Sterile Processing - Thought of the Week

Where Do They Go - Missing Instruments in Sterile Processing

It is the age-old question, where do the missing instruments go in Sterile Processing? The answer is not always known, but we do know that there are several answers to the question:

  • The trash

  • Co-mingled in wrong sets

  • Left in the wrong sets

  • Broken

  • The linen

It is often thought that missing instruments begin the journey to the unknown in SPD. That thought process is usually a fallacy. SPD, in most cases, is left to clean up others' messes. A typical day in SPD can see hundreds of instruments return in the wrong surgical instrument sets. SPD can contribute to the issue when SPD technicians leave instruments that don't belong to a set in a set. In hospitals that process their linen, SPD can have instruments returned to them by the hundreds.


Measuring Loss

One of the great advantages of having an instrument tracking system is being able to see what sets were produced with missing instruments. Not all SPDs will put up sets with missing instruments, but you still have a way to track and measure your loss. Daily reviews of your assembly process will give insight into the missing instruments, and if you add value to them in your tracking system, you will also be able to see your loss in dollars. But beware, not all missing instruments are lost. By removing improperly placed instruments, you may still have them. You just do not have the instruments where you need them when you need them in most cases.


How To Reduce Loss

Reducing loss is best resolved by a partnered process. Working with your end-users to get the instruments back into the correct trays before returning them to SPD is probably your greatest value. Other avenues are passive use of RFID systems, metal scanners (which have not been that successful), or resourcing additional SPD staff in the turnover process. Lastly, finding a way to manage the instruments that were pulled from sets so that they get back into your inventory ready for deployment quickly will pay good dividends.


Partnership Not Finger Pointing

Developing steering groups to work through process issues is a great way to develop partnerships. Throw your titles at the door and start working on win-win solutions. Build a charter that outlines the group's purpose and vision, scope, principles, goals, deliverables, and operating procedures/communications, and you will be on your way to solving your process issues.



Next to the OR and SPD staff, the instruments are the most significant value to maintain. Continued miss management of your instrument inventory costs the institution in lost resources. One of the greatest resource losses is time, which can influence all other aspects of how both the OR and SPD run.



At Evolved Sterile Processing, our consultants have a greater focus on sterile processing. With our decades of experience, we will help you develop better processes and educational resources for your staff.



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