Gestão estratégica utilizando a metodologia Lean na recepção de produtos para saúde no centro de material e esterilização

Abstract

It is essential to designate a specific area for the reception of medical devices in the decontamination section of the Central Sterile Supply Department (CSSD) to ensure the success of further development processes. Brazilian CSSDs tend to be located in areas that are not large enough to handle their work demands and several reception processes are not standardized. Objective: Implementing a work station with Lean Strategy for the reception of medical devices at the decontamination section of a CSSD. Methodology: Exploratory, descriptive and interventional studies to be developed in five methodological phases: 1st phase: evaluation of physical infrastructure utilizing a verifying instrument that categorizes areas of the decontamination room (category I–reception area for surgical instruments (SI) from the operating room (OR); category II–cleaning area; category III–common area for reception and cleaning; category IV–area for counters); 2nd phase: mapping of the flow of medical devices; 3rd phase: application of tool 5S; 4th phase: implementation of a new flow design to process medical devices; 5th phase: CSSD professionals answer a questionnaire regarding the implementation of the new work station. Results: 1st phase: from the nine items evaluated in category I, 22% were inappropriate. However, by purchasing a cart with shelves and elaborating as well as implementing a reception of medical devices register form, 100% of the demands were met; category II 100% was accordingly; category III only 14% of the washer area requirements was accordingly; to minimize problems, alcohol solution dispensers 70% were installed; and in category IV, 50% was not according to specifications so the following changes have been made: water pressure faucets have been installed in counters 1 and 2, device processing has been transferred to counter 4 and the designated time for the processing of respiratory devices has been changed. 2nd phase: Flows of SI and utensils; cannulated instruments; electronic devices; and ventilation assistance materials and containers have all been mapped. 3rd phase: Utilizing tool 5S has resulted in 43 actions: Seiri– extra materials have been taken away and broken ones have been discarded. Seiton -allocation of furniture and cleaning agents for efficiency. Seiso professionals that operate equipments work efficiently and zealously. Seiketsu – establishing a standard procedure to moisturize SIs; potable water filters of 0,2 micra should be used for rinsing medical devices. Shitsuke – implementing new work processes for seiri, seiton, seiso, seiketsu has caused the need for continuing education. 4th phase: two flows of SI and cannulated have been altered. 5th phase: 100% of the professionals we have worked with have approved the implementation of the new work station. Therefore, this study of the Lean Strategy Implementation has caused the identification of problems and the organization of work environment always bearing in mind infection control, work rationale and the well-being of all professionals at the CSSD.