The COVID-19 pandemic brought supply chain issues to the forefront, as hospitals and other healthcare settings struggled to provide sufficient personal protective equipment to staff. But even before recent events, hospitals, especially operating rooms (ORs), have long struggled to address supply chain challenges to reduce costs and improve efficiency. Having the right supplies at the right time for the right patient is an essential part of delivering optimal patient care, but too often, this ideal isn’t met. It’s up to nurses, in their role as patient advocates, to understand the effects of and reasons for supply chain problems and to take a leading role in addressing them.
American Nurse Journal recently spoke about these issues with two perioperative nurses at Good Samaritan Medical Center in West Palm Beach, Florida. Deena Carney, BSN, RN, MHA, CNOR, is director of surgical services, and Heather Salvatore, BSN, RN, CNOR, is the robotics coordinator. Good Samaritan has 12 ORs and performs about 5,700 cases a year.
Effects of supply chain issues
Supply chain issues affect patients, frontline nurses, nurse leaders, and organizations. Patients may experience harm when the right equipment isn’t available at the right time, forcing nurses to leave the room to track down supplies. “Anything can change in the blink of an eye,” Salvatore says about this patient safety issue. “You never know when the surgeon or anesthesiologist might need something or something could go wrong.”
Frontline nurses experience stress when they don’t have the supplies they need and are on the receiving end of surgeons’ dissatisfaction. Salvatore cites a recent example of having four cases of the same procedure, each with different supplies. “It gets very frustrating,” she says. Carney notes that because so much of the OR is technologically advanced, it’s difficult for staff to understand why basic inventory can’t be accurate.
Nurse leaders can lose staff (a recent survey of nurses by Syft found that 18% have considered leaving their current role due to supply chain problems) and see negative budget variances as a result of staff turnover and lost revenue because supplies aren’t documented. In addition, not having the right supplies can result in case delays. Balancing the need for sufficient supplies on hand and the costs of overstocking can be challenging. “You don’t want too much inventory on the shelf, but you want to have what you need,” Carney says.
Organizations lose revenue when supplies aren’t documented and unnecessary supplies are opened but can’t be billed to patients; organizations also suffer from staff turnover costs.
Sources of supply chain issues
Causes of supply chain issues include outdated surgeon preference cards; lack of technology to facilitate automated replenishment; cumbersome documentation requirements (such as poor electronic healthcare record [EHR] interfaces); and, most importantly, lack of input from frontline nurses about their ideas for improving processes and when decisions are made about products and workflow.
Carney and Salvatore have seen some of these issues at Good Samaritan. “The biggest supply chain challenge is having the right supplies in the OR,” Carney says. For example, outdated surgeon preference cards can lead to staff gathering the wrong supplies for a case. Another problem arises when products are replaced because of cost considerations, but the OR staff isn’t notified.
What nurses can do
Frontline nurses and nurse leaders can play a role in addressing supply chain issues. Carney and Salvatore provide several strategies.
