Paper Count Sheets

SEPTEMBER 2000, VOL 72, NO 3 LETTERS

PAPER COUNT s

I

nm

would like to comment on an answer given in the June 2000 “Clinical Issues” column (page 1275). The question was regarding the appropriateness of placing paper count sheets in instrument trays as a check mechanism. Computer-generated printed count sheets have been placed in instrument sets for years. The paper is normal, multipurpose printer or typing paper. The print is accomplished with laser toner, the same that is used in copy machines. These products leave no residue, staining, or discoloration on instruments, instrument containers, or sterilizers. To manually write all the information, as suggested, and then file the papers to be attached to instrument trays later, is very laborious, tedious, and inefficient. The process you described reinforces manual processes that most hospitals are choosing to improve through automation. There are numerous instrument inventory tracking systems on the market that now automatically generate a printed count sheet with reconciliation columns for counts. The more sophisticated systems provide not only instmment name, vendor, and catalog number, but also specific pictures of that item.

This ensures accurate tray assembly, as well as ongoing education. These systems also provide accountability by capturing employee names, time to assemble trays, and the exact location of instrument rays. These features provide accountability and management reports necessary to track employee and departmental productivity. These count sheets are placed in the instrument tray and follow that tray throughout the instrument cycle process. Data is automatically collected that shows the complete and incomplete status of trays, what instruments are missing, and where trays are located at any given time. DEBORAH HALEY RN, MBA, CNOR VICE PRESIDENT, PERWPERATIVE SERVICES APPLIED LOGIC, INC

BRADENTON, Fu

Author‘s response. AORN is aware that automated systems are being used in some facilities. Many facilities, however, do and will continue to use manual systems well into the future, before moving to a more automated world. Whether a system is manual or automated, it is possible for chemicals from the paper to leach out into the sterilizer. I have heard of people putting paper count sheets into sets for years without incident.

376 AORN JOURNAL

I also have heard of people who spent thousands of dollars checking sterilizers, steam quality, steam lines, facility boilers, and chemicals used only to discover that the residue buildup in the sterilizer and on the instruments disappeared when paper count sheets were removed from the set and added after the sterilization process. DOROTHY M. FOGG RN, MA SENIORPERIOPERATIVE

NURSE SPECIALIST

TREATING GLAUCOMA

I

recently read the article titled “Treating glaucoma with drainage devices and pericardial grafts” in the June 2000 issue of the AORN Journal. The article was very interesting, but it left out the use of antimetabolites, such as mitomycin C, that are used on the scleral surface and subconjunctival tissue after performing a trabeculectomy. Antimetabolites are used to decrease the likelihood of fibrosis and scar formation in blebs and to increase the success rate of infiltration. Mitomycin C is used along with the trabeculectomy in patients with glaucomb by the ophthalmologist at &ne General Hospital, Wayne, NJ. DEBRA DUNN RN, MBA, CNOR WAYNEGENERAL HOSPITAL WAYNE,NJ