tem without acknowledging the huge role it plays in your workflow
can be a costly lesson, believe me. I once managed a purchase that
inspired an AORN poster titled "How Not to Implement a Case Cart
System" (osmag.net/r7NHZc).
If you think about case carts at all, you probably see them as a con-
venient solution for transporting surgical supplies to the OR. While
that use certainly keeps your staff from having to haul armloads of
trays down the corridor themselves, carts also address infection pre-
vention and quality care concerns.
Case carts help to safeguard the sterile integrity of surgical instru-
ments and supplies until they're ready for use in a procedure. They
accomplish this largely by limiting the movement of the items that are
pulled for a case. Removing items from the supply room shelf and plac-
ing them right into a mobile cart that's taken directly to the OR reduces
the number of times those items are touched, handled or moved during
case preparations, as well as the number of opportunities to damage or
contaminate blue-wrapped instruments or packaged supplies. A closed
cart system that stores items behind doors adds another layer of protec-
tion.
Carts also safeguard the passage of used instruments on their way
to the sterile processing department after surgery. Contaminated
instruments can contaminate your environment, but containing them
in a closed cart or at least covering them on an open one can pre-
vent the scatter of debris while they're in transit. In the course of my
30-plus years in surgery, I've worked at facilities where used instru-
ments and supplies were stacked on top of OR tables after surgery,
covered with drapes and wheeled to central sterile, so it goes with-
out saying that carts enable much cleaner and more efficient
turnovers.
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