Effectiveness of Guidelines for Reducing Re-sterilization of Extra Surgical Instruments in the Operating Room, Nongbualamphu Hospital.

Abstract

      This study was quasi experimental research aimed to evaluate the effectiveness of guidelines for reducing re-sterilization of extra surgical instruments in the operating room by comparing the number of cycles in which extra surgical instruments required re-sterilization before and after implementing the guidelines at Nongbualamphu Hospital. This an interrupted time series design with retro-prospective data collection. The study was conducted on extra surgical instruments across six surgical departments: General Surgery, Obstetrics-Gynecology, Urology, Orthopedic Surgery, Ear-Nose-Throat and Oral-Maxillofacial Surgery, and Ophthalmologic Surgery. Data were compared across two alternating time periods: Phase 1 collected re-sterilization data using the conventional method for 28 cycles, and Phase 2 collected data using the new method for 28 cycles. Data were collected from May 2025 to January 2026. Data were analyzed by Descriptive statistics including frequency, percentage, mean, and standard deviation were used. Study outcomes were analyzed using multivariable multilevel regression to adjust for baseline characteristic differences.

      Results: A total of 143 extra surgical instrument sets were identified across departments. After regression analysis, the guidelines for reducing re-sterilization of extra surgical instruments reduced re-sterilization by an average of 2 cycles (95% CI: −3.58, −0.08; p = 0.040) and reduced the incidence of expired sterile extra surgical instruments by an average of 16 cycles (95% CI: −22.28, −10.05; p < 0.001), both statistically significant compared with the conventional approach. The cost savings from replacing the conventional approach amounted to 10,064.961 baht.