Next-level Power Tools

New features in ever-evolving drills, saws and other instruments improve performance and comfort for surgeons while increasing safety for patients.

Ultimately, the power tools you buy wind up in surgeons’ hands for challenging orthopedic procedures, so they must be satisfied with the devices that are available at your facility.

It also remains important that your perioperative teams — surgical technicians, circulators, nurse assistants, nurse practitioners, sterile processing staff — are trained on how these tools are used to create maximum efficiency, says Ashley Bartholomew, BSN, RN, CNOR, ONC, an OR nurse at OrthoVirginia in Alexandria. “We recognize the surgeon primarily uses the tools during procedures, but all team members can benefit from a deeper understanding of the challenges during critical moments of orthopedic surgery,” she says.

That’s why it’s important to develop engaging ways to “power up” your staff’s skillset and competence with the tools used in joint replacements and other surgeries. At OrthoVirginia, Ms. Bartholomew has participated in numerous such initiatives, including competitive games such as target practice with K-wires and Connect 6 with wire drivers. The games were played during short periods of free time throughout the day. Staff were also trained on how to minimize bone loss when saws are used.

In a post-event survey from one of these in-service sessions, 100% of participants gave positive feedback, saying the exercises were exciting, engaging and improved team morale. Everyone also said they’d recommend the training to other OR teams.

Three-quarters of respondents noted the training helped them become more familiar with the fleet of power tools they work with and the supplies connected to them.

“Through comprehensive education and training, team members gained a deeper understanding of each other’s roles and responsibilities, fostering better collaboration and synergy,” says Ms. Bartholomew.

She suggests reaching out to your power tool vendors for training ideas, making sure all appropriate employees are welcome to participate and offering flexible times for the programs to increase the amount of people who can participate.

“Add elements of friendly competition to draw attention to it,” says Ms. Bartholomew. “Have fun!”

A power tool wish list

Keep these vital considerations in mind to make smart power tool purchasing decisions.

• Ergonomics. Power tools are extensions of surgeons’ hands, and they often perform multiple joint replacements each day. So comfort is key. As Philip G. McDowell Jr., MD, of OrthoTennessee, has told OSM, the various specs of a power tool matter little if it doesn’t feel good in the surgeon’s hand.

Weight and balance are particularly important considerations with battery-operated tools. Be aware of the battery’s size and how much of the device’s total weight it comprises. As Joseph S. Park, MD, of University of Virginia’s Department of Orthopedic Surgery, has told OSM, ensure batteries are attached as surgeons trial these tools. Often, devices feel light without the battery but might be heavier than they’d like with the battery attached.

Taller surgeons don’t want to be forced to crouch or lean into the patient while working, says Dr. McDowell, while other surgeons have their own valid preferences. Tools that are too heavy, imbalanced or awkward to operate either won’t be used well or won’t be used at all. A tool that’s too heavy could also make it more difficult for surgeons to apply the right amount of force needed to drill or cut through bone safely and effectively. Many surgeons, therefore, prefer lightweight options that still have the power to get the job done.

The handpieces of these devices should be comfortable and easily gripped, as surgeons have very strong opinions about how a tool feels in their hands. Excessive vibration can also contribute to a new tool not being used. Make sure any new items you purchase are comfortable enough to ensure they’ll be used regularly and not contribute to surgeon fatigue.

• Power. There are different considerations for small-bone tools, many of which are corded, and the predominantly battery-powered tools for large bones. For the latter, Gregory P. DeConciliis, PA-C, CASC, administrator of Boston Out-Patient Surgical Suites in Waltham, Mass., has told OSM to make sure you know how long batteries last on a single charge. Will it be enough to keep them operational during high-volume days?

Know how many chargers you’ll need, the battery’s typical shelf life and how long it takes for a new battery to arrive. For corded tools, consider where they will be plugged in and if a separate power console will be required.

GAMIFIED Turning training programs into a competition is an effective way to teach OR teams how power tools work.

• Reprocessing concerns. Power tools must be able to withstand the rigors of multiple daily cleanings. Before purchasing, evaluate the tool’s instructions for use (IFU) regarding critical tasks such as sterilizing the battery. Learn if a device can be run through an autoclave or if it needs to be processed with a low-temperature sterilizer, says Mr. DeConciliis. Must it be individually wrapped or can it be placed in a larger instrument tray? Determine if you have the storage capacity for new items that require their own trays.

• Involve your team. Dr. Park notes that involving nurses, scrub techs and sterile processing staff in the power tool purchase process so they know how the devices come apart and get put back together. Dr. McDowell says an uncomplicated design is important. Surgical techs and nurses should have a working knowledge of how the tools work and how surgeons use them during complex cases.

• Noise, function and versatility. Surgeon preference will ultimately determine whether a noisy tool will work in an OR, so get consensus on the acceptability of a tool’s noise level during the trial period. Speed — the number of revolutions a drill bit makes, and torque, the number of cycles a saw blade completes in a given amount of time — are also key considerations. High-speed drills are more precise and easier to use, while sufficient torque is vital to overcome friction that occurs while digging into bone. Tools that rattle excessively are often unpopular with surgeons and OR teams, while blades or bits with too much wobble make cuts or drilling holes more difficult.

• The trialing process. Document surgeon feedback on the accuracy and performance of the tools you are considering. Involve other members of the OR team and sterile processing. Have everoyone fill out evaluation forms after the trailing process and refer to their comments when it’s time to make purchasing decisions. During trialing, engage the vendors about warranties, the costs of the attachments for the tools and other ancillary considerations.

While price will always be an issue, Mr. Deconciliis says he always chooses quality over cost, noting it makes more sense to invest in a tool that lasts longer, performs better and is more efficient. OSM