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Recommendations by the Quality Task Group
[21] Why Computerised Documentation? - Reflections from the Field

With computerised documentation, everyday routine activities in the CSSD can be managed more effectively and efficiently. Networking of several workstations with associated integration of washer-disinfectors and steam sterilisers is a highly topical subject in the CSSD. To meet the QUALITY MANAGEMENT REQUIREMENTS governing the processing of medical devices (see Guideline of the Robert Koch Institute of November 2001), it can be very beneficial to use electronic data processing to document this procedure.
Using computerised documentation, all tasks performed in the CSSD are stored on the computer. Process control data for washer-disinfectors and steam sterilisers are likewise stored on the hard disk. Hence, one can verify which staff member had packed a particular a tray or set at what time and in which steriliser it was sterilised. The processing details relating to a device can be documented, even in the patient’s notes, without any major effort on a label that is printed out after sterilisation for each set and affixed to the tray or set.

What is needed?
To begin with, the hardware (PC, printer, scanner, etc.) must be in place. The software (programmes for use in the CSSD) should be purchased only after in-depth reflection and consultation with the hospital’s IT department. Here it is important to assure compatibility with any other existing IT facilities.

Advantages of computerised documentation
The advantages conferred by a computerised system, in addition to verification of medical device processing, include:

• The location of the trays can be established by computer
• Tray lists can be updated without delay by authorised personnel
• The tray lists can also be viewed on the screen by OR personnel and printed out if necessary
• A check can be carried out without any extra major effort to establish where a set had been used and verify its expiry date
• Automatic recall requests at the expiry date

The "CURRICULUM VITAE" of an individual instrument can also be tracked on the computer. Since each new instrument has its own individual number, any necessary repairs can be documented and the duration of repair checked. Withdrawal of an instrument and replacement with a new one can also be documented on the computer.
Once the onerous task of registering all devices has been completed, a computerised system makes it easy to keep track of all materials that are needed in a CSSD. One can thus ORDER NEW INSTRUMENTS much quicker and also keep track of other items.
The advantage of the computer when it comes to TRAINING NEW STAFF MEMBERS should not be underestimated. For instance, from the computer data one can see which sets have already been packed by new staff members on many occasions and where there is still a need for training. Depiction of the instruments facilitates the learning process for the new staff members. This is especially true for old instruments or instruments which had been specially manufactured and have no discernible article number.

IT and CSSD personnel
The name of each CSSD staff member working with the computerised system is registered in the user master data. These master data specify the authority assigned to the respective staff member as regards use of the computerised system.
This is how easy it is to integrate personnel into the system. But this does not mean that the staff member is able to manage a computer. There is a major need for TRAINING as regards using computers, barcode scanners, etc. Many staff members will never have used a computer and will have to overcome initial anxiety; this matter must be taken seriously. Already at the planning stage, staff training should be initiated so that mishaps are avoided when it comes to actually using the computerised system in practice.
After good preparation and training, staff will be able to work confidently and competently with the new equipment.

Outlook for the future
The use of computerised documentation can facilitate many of the procedural steps involved in medical device processing in the CSSD. It is certainly easier to implement a comprehensive quality management system with IT support than it would be without such a system. Cost transparency in the CSSD can also be important in the context of the planned introduction of the new system for calculating the cost of hospital services (Diagnosis Related Groups (DRGs) and flat-rate case fees). A sterile supply logistic programme linked to the hospital’s computerised system can facilitate this.