HSPA: Instrument Marking: Taping Do’s and Don’ts

INDUSTRY INSIGHTS

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Figure 1. Peeling, chipped or cracked instrument marking tape can jeopardize patient safety. When detected, instruments should be removed from service until the tape and adhesive residues are removed and properly replaced.

Instrument Marking: Taping Do’s and Don’ts

By David Taylor III, MSN, RN, CNOR

Surgical instrument inventories come in all shapes and sizes, and today’s sterile processing (SP) professionals have the seemingly insurmountable task of knowing thousands of instruments used within their health care organizations on a day-to-day basis. Beyond that, they must sort through hundreds of tangled trays to ensure the right instruments go into the correct instrument set.

As a result, many SP departments (SPDs) use various instrument marking methods – mostly mechanical – to help their technicians identify surgical instrumentation to facilitate their separation and assembly and determine to which set or tray a given instrument belongs. This process even helps lessexperienced SP professionals carry out the set assembly process.

Health care organizations vary and so do their instrument needs; therefore, there is no one-size-fits-all solution when it comes to surgical instrument marking. The best marking methods for an organization will depend on the complexity of their surgical program, the number of sets in each specialty’s inventory, the type of instrument and sterilants used, and the SP professionals’ skills.

Device marking options

Electrochemical, laser marking and marking tape, and dots or dipping (mechanical) options are currently available. Each method has pros and cons and needs to be carefully considered before a method is chosen.

Identification marking tape is one method widely used. If one’s organization uses this method, they must keep in mind that the Joint Commission (TJC) is actively seeking out those instruments and scrutinizing them during their surveys. TJC will not only inspect instruments in service (in sets and peel packs) but also those that sit in a bin or drawer.

Marking tape is intended to adhere to a stainless-steel surgical instrument to help with identification, organization, management, proper processing and packaging of these items. Tape comes in various colors, patterns and alphanumeric coding options that allow SP professionals to identify instruments in different ways as they move between the SPD and operating room (OR) and other departments. Instrument tape helps SP technicians save time by effectively organizing and identifying surgical instruments.

If instrument-marking tape methods are used within an organization, the tape must be maintained. Cracked, chipped or peeling instrument tape (See Figure 1) can harbor bioburden and harmful pathogenic bacteria. In addition, dry, flaking tape can dislodge and remain in a patient’s wound (retained foreign body), and the glues used to adhere these tapes may prevent steam from penetrating, making those instruments impossible to sterilize effectively. Ensure technicians have a copy of the manufacturer’s instructions for use (IFU) for the product currently in use. It is also important to consider the costs involved. Maintenance is key and the costs will include the material, time it takes to apply the material, and the labor involved to maintain it. If contracting with a surgical instrument repair service, they should be able to maintain it, usually at an additional cost. Still, SP leaders and

their teams will be responsible for rotating the instruments through this service as needed.

Not all tape is the same

Although instrument tape can be used to mark instruments, each manufacturer’s technical data should be verified and validated for use with the different sterilization methods in use in one’s organization. The tape used must be manufactured specifically for this purpose and withstand repeated washing and exposure to chemicals and sterilization cycles. It must also be able to adhere to the instrument during surgical procedures and not peel or flake off.

Note: Not all marking tape can be used with all sterilization methods. The tape manufacturer’s IFU should be checked to ensure the sterilants in use at the facility can penetrate the tape during the sterilization cycle.

General application guidelines

Proper application is critical when using marking tape. The tape should be wrapped no more than one-andone-half times around the application area of the device, and the tape should not be stretched when applied; it must lie flat, with no gaps, and it must be applied in an area that will not contact the patient or cause interference for the surgeon.

Instruments marked with tape should be carefully inspected for integrity and proper application. If the tape begins to chip or peel away from the instrument, it should be immediately removed from service. All tape material and adhesive residues should be completely removed (chemical tape removers are commercially available). Instruments should be checked each time the instrument is processed, and the instrument must be cleaned and dried prior to re-taping. When marking tape is changed, it should be documented.

Warning: Never use a sharp object (such as a knife blade or another instrument) to remove tape. These methods can damage the instrument’s finish and may cause employee injury.

Conclusion

Managing the number of instruments and surgical sets that pass through an SPD in a 24-hour period can be overwhelming. For some organizations, so many instrument trays pass through the SPD that it is not uncommon for several hundred trays to be down at the start of the new business day. Processes such as instrument marking can have a significant impact on SP processionals’ ability to process more instruments during their shift; however, these methods must be properly maintained and inspected each time the instruments are reprocessed.

– David Taylor III, MSN, RN, CNOR, is an executive health care consultant for Resolute Advisory Group LLC, based in San Antonio, Texas. He has served as a contributing author for HSPA since 2019.

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