Surgical instrument tracking is software that follows each tray of surgical instruments through cleaning, sterilisation and storage, and back to the operating theatre. A hospital owns thousands of instruments, such as scissors, clamps and retractors. They are grouped into trays, and one hip replacement may need four or five trays. After every operation, each tray must be cleaned, checked, packed and sterilised before it can be used again.
This work is done in the central sterile services department, or CSSD. It is a separate department, often in the basement of the hospital. Without tracking, the CSSD works from paper lists. A tray can come back with one clamp missing. It can be sent to the wrong theatre. And nobody can prove later which tray was used on which patient.
The software gives each tray, and often each instrument, an identity. Usually this is a barcode on the tray, or a small code etched into the steel of each instrument and read by a scanner. Some hospitals use RFID tags, small radio chips that a reader can detect without a direct line of sight. At each station, an employee scans the tray. The screen then shows a photo of the packed tray and a list of the instruments that belong in it. The employee checks each instrument before packing.
Consider a hospital in Bhubaneswar that runs 40 operations a day. At 6 p.m., the operating room schedule for the next day shows two spine operations first thing in the morning. The tracking software puts the two spine trays at the top of the CSSD's work list. At the packing station, an employee scans the first tray, and the screen lists 62 instruments. One retractor is missing. The software shows that it was scanned into another tray from the same theatre, which is still in the washer. The tray is completed and goes into a steam sterilizer. The sterilizer's cycle record, with its temperature and its time, is stored against the tray. By 7 a.m., both trays are on the shelf outside theatre 1.
During the operation, the nurse scans each tray against the patient. If the patient later develops an infection, the hospital can see which tray was used, which sterilizer cycle it went through and who packed it. Recording each step of an item's journey in this way is called track and trace.
The software also counts how often each instrument is used. So the hospital knows when an instrument needs sharpening or repair, and when it owns too few trays for the number of operations it runs. Some hospitals also use a real-time location system to find a tray that has left the department.