I am Floracy Ribeiro RN, MSN from Heart Institue - InCor DF - Zerbini Foundation - Brasilia - Brazil

I have some doubt about using of color coding system to identify surgical instruments.
I believe that is difficuld the cleaning process penetrate under the tape.
Somewhere has a research about the efectiveness of cleaning process under the tape? How is the frequency of change it? Otherwhise our surgeons are against electrochemical permanently mark.
We (nurses) keep the position of permanently mark to management and control, because we developed a code for each container and instrument who will help us in develop a bar code control. Thank you.

Dear Floracy

Color-coding tape for instrument marking is properly still the most widely used system for instrument identification.
The tapes are normally resistant to acids, alkalis and oils and are unaffected by regular cleaning or sterilization. However special inspection during cleaning and preparation is necessary to ensure that the tape is in tact and no bioburden is accumulated. If the integrity is compromised it should be replaced. Ask the manufacturer of the tape you use how long it can stay on under normal usage.
The right technique for applying the tape is most crucial. It is important to follow the manufacturer's instructions for correct application that in general are:

• Ensure that fingers are clean and dry.
• Instrument should be freshly washed and de-greases by wiping with alcohol
• The tape should be applied on a part of the instrument where it is not tapered and therefore will remain flat.
• The tape should wrap 1 ½ to 2 times around the device. Apply the tape with a firm, pulling tension. Cut the tape on an angle (this allows the edge to lay flat.).
• The instrument should than be autoclaved. This effectively shrinks the tape around the instrument and sets the tape to tape adhesion. The steam penetrates between the tape and metal and dissolves the adhesive.
• The instrument should then be washed in the normal fashion and can then be circulated.

You have a good question about the effectiveness of the cleaning process under the tape. I am not aware of any study done on this subject. An experimental study was published in the Journal of healthcare material management (October 1993) on "Flash sterilization and instrument tape". by David A. Kostyal a.o. (Unfortunately the Journal doesn't exist anymore.)
The experimental approach was undertaken to test the hypothesis: That color tape require a longer time to penetrate when flash sterilization was used. Spores on discs were placed between the color-code tape and a metal instrument. exposure to heat 135°C and time (3 min.). The test organism was B.stearothermophilus. All samples were negative for growth i.e. sterility can be achieved on the instrument surface that are beneath the color-code tape in three minutes.
What I read in your question is that your aim/wish is to install a Total Instrument Management System, scanners with computer stations to read bar codes affixed to instrument sets, which allows you to keep track of instruments, whether they are in sterile processing, in the operating room, in repair ect. That is the best choice you can make- it is the future system for CSSD. With the keyword: Tracking (tracing) system for surgical instrument you get a mass of positive arguments/information to convince your surgeons.

Kind regards
Josy Holdener