More than nine in 10 (91 percent) respondents to a survey of more than 1,500 surgical facility managers (see "Which Purchases Do Surgical Facility Managers Influence?") say they have buying power over everything from gloves and gowns to sutures and scrubs.

"I have a great deal of purchasing influence," says Debra Straw, CST, the materials manager at Allied Physicians Surgery Center in South Bend, Ind. "I'm where it starts. If somebody wants to add something to our inventory, I'm the gatekeeper. I have the ability to make the decision whether to add to our stock or not."

Yes, long gone are the days when physician preference was the first - and sometimes only - consideration in the buying decision. But what exactly goes into deciding which supplies you buy? What factors do you consider when choosing between this glove and that glove? To answer these and other questions, we conducted a survey. Read on to find out what we learned from the 55 surgical decisionmakers who completed our 22-question Web-based survey on surgical-supply buying habits.

Drapes
Imperviousness (34.5 percent) and price (29.1 percent) are the two most important considerations when deciding which drapes to purchase, according our survey.

"Doctors pick and choose the drapes that they like. My job after that is to negotiate the best price that I can," says Chris Holmes, the purchasing manager of the Oregon Eye Surgery Center, an eight-physician ophthalmology facility in Eugene, Ore.

Gowns
Our survey found that facility managers consider imperviousness (30.9 percent), comfort (21.8 percent) and price (20 percent) when deciding which gown to purchase.

"Weight's an important factor. The gown needs to be cool when worn," says a surgery center CEO.

Gloves
The challenge in purchasing gloves is a bit more complex. As Ms. Holmes puts it, your mission is to "find one brand of gloves that eight surgeons agree on at a good price."

Our respondents rated material (30.9 percent), price (16.4 percent) and tensile strength (16.4 percent) as the most important factors when deciding which glove to purchase. "The ability to feel, touch, pick up small objects and strength," says one administrator.

"Strength and cost," says Roxanne Baden, the director of surgical services at the Center for Orthopedic Surgery, Inc., in Van Nuys, Calif. "Glove allergies are a factor as well."

Hand Hygiene
Nearly two-thirds (63.6 percent) of our respondents rated effectiveness as the No. 1 factor in deciding which hand hygiene products to purchase. Antiseptic agent (16.4 percent) and price (7.3 percent) are lesser considerations.

"Compatibility of the gloves and antiseptic," says one administrator. "I consider the recommendation of our infection control nurse," says another.

Patient Preps
Interesting to note that several survey respondents in their write-in comments say that physician preference plays a key factor in which prep their facilities stock. Writes one administrator: "We stock multiple preps based on surgeon preferences."

Nearly one-half (49.1 percent) of our respondents rated the prep's effectiveness as the most important factor. Other key factors included active ingredient (17 percent), residual efficiency (9.4 percent) and price (7.5 percent).

Surgical Packs
More than one-third (35.8 percent) of our survey respondents look to purchase surgical packs that are customizable. More than one-fourth (28.3 percent) are looking for the best price.

Ms. Baden from the Center for Orthopedic Surgery mentions "dependability and the history with the company and the product" as important factors.

Wound Closure
Here is another supply category where physician preference is a key consideration. "Physician preference, then price", says Dawn Q. McLane RN, the executive director of the Allied Physicians Surgery Center in South Bend, Ind.

Price and material are equally important, according one-fifth (20.8 percent) of our survey respondents. Other factors in selecting wound closure devices include closure time (11.3 percent) and absorbability (7.5 percent).

Surgical Blades
The best price is most important for more than one-fourth (26.4 percent) of managers, according to our survey. More than one-fifth (22.6 percent) are looking for blades with safety devices. Fifteen percent give special attention to a blade's sizes as well as its material and sharpness.

Safety Devices
Here, we were interested in learning which safety devices facility managers purchase for their facilities. We asked our survey respondents to check all that apply. The results:

• IV catheters (83.3 percent)
• syringe needles (72.2 percent)
• hypodermic needles (68.5 percent)
• blades and scalpels (46.3 percent)
• suture needles (29.6 percent)
• regional block needles (18.5 percent)

Many commented that safety devices must, above all else, be easy to use.

"The staff evaluated and made their own selections based on ease of use," says Linda M. Nash, MBA, CASC, LHRM, the administrator/risk manager of the Manatee Surgical Center in Bradenton, Fla.

"We conducted a trial and gave strong consideration to ease of use," says the administrative director of a surgery center. "When something is difficult to use, people will continue to revert to old habits."

Says another: "We tried several different manufacturer's samples and allowed staff to chose the ones they liked best. End users will adapt more easily if they are included in the purchase decision."

"The safety device can't interfere with the normal 'flow' of the task," says Ms. Baden. "There also shouldn't be many different accessories to purchase to make it work."

Finally, Marlene Brunswick, RN, the director of nursing at the Findlay Surgery Center in Findlay, Ohio, says she's held off on purchasing some safety devices. "Safe practices," says Ms. Brunswick, "can be as safe as some safety devices."

Latex-free
Here are the latex-free supplies our survey respondents purchase:

• gloves (94.3 percent)
• anesthesia circuits (81.1 percent)
• anesthesia masks (81.1 percent)
• IV access ports (79.2 percent)
• catheters (79.2 percent)
• tourniquets (73.6 percent)
• bandages (71.7 percent)
• drapes (71.7 percent)
• syringes (64.2 percent)
• EKG electrodes (62.3 percent)
• surgical caps (58.5 percent)
• blood pressure cuffs (50.9 percent)