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Draft content for Intro to SPD Module
Section Eight: Distribution
This module covers:

Estimated
Contact
Time:
45 minutes
distribution, the process of providing medical supply items to the
user wards, clinic units, and operating room suites. Accurate,
efficient, distribution of equipment and supplies is critical to
providing quality patient care. If the correct supplies dont reach
their intended user in a useable condition, then the
decontamination, sterilization, and storage processes are just a
waste of time.

Distribution
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The contents of this manual are the sole property of the Department of Veterans Affairs and may not be
used or reproduced without permission.
Following instruction, you should be able to perform the following:

Identify distribution and delivery methods and procedures,
including:

o

five main distribution types
o

types of specialty carts and their use
o

delivery methods and equipment
o

delivery procedures and equipment tracking


Distributing Supplies


The distribution area is the center of the Supply, Processing and
Distribution organization. Its purpose is to stock, maintain, and
distribute sterile and clean medical supplies and equipment to the
user areas for patient care needs. Items are usually distributed to
the ward and clinic areas according to a prearranged schedule and
to operating rooms on a daily basis, depending on the procedures
that are scheduled.

SPD technicians must be familiar with the names and uses of
supplies and equipment, and be able to deliver them, where they
are needed, when they are needed.
When clean and sterile supplies are needed in the user areas of the
healthcare facility, they must be transferred from the SPD
department to the point of use. This distribution is requirement
driven. The number and type of supplies, who needs them, when,
and where, are all factors which determine the type and method of
distribution. It is important for you to understand the
characteristics and advantages of each type and the reasons for its
use in your medical center.

SPD uses five main distribution methods to ensure the right
product is delivered, in the right condition, at the right time.
Par level
Demand
Exchange cart
Case cart
Specialty carts

Par Level Distribution
For most healthcare facilities the par-level system is an excellent
means of managing user needs while controlling inventory. It is the
most commonly used system and should be considered for all
common use items. In a par level system, the SPD technician
conducts routine inventories of supply closets, treatment rooms,
and nurse-servers to determine what has been used. Supplies are
replenished based on a pre-established or par level which has
been set through communication with the end user. Par levels must
be reviewed frequently and changed, if necessary, to reflect actual
usage.

The SPD Technician is responsible for reviewing the stock levels
and communicating with end users if changes are required.

A typical procedure for maintaining par level inventories is to
assign a technician to each area or department. The technician
inventories supplies in the treatment rooms, supply closets, and
other storage areas using a bar code scanner and generates a list of
the needed supplies. S/he then returns to the SPD department, fills
the order and delivers the supplies to the user areas, restocking
items to the agreed upon level. In healthcare facilities that use
nurse-servers for storing patient care supplies, a pre-stocked mobile
Distribution
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The contents of this manual are the sole property of the Department of Veterans Affairs and may not be
used or reproduced without permission. cart may be used to restock the servers to par level. A list of all
required items and levels is posted on the door. The SPD technician
uses supplies from the cart to replenish the nurse servers on a
scheduled basis. The SPD technician is responsible for keeping the
cart stocked with all necessary supplies.

Demand Distribution

In demand distribution, the user
area staff is responsible for
maintaining adequate supply levels.
They determine their needs, and
request items from SPD. This can be
done in person, by phone, or online.
An SPD employee pulls the
requested items from inventory and
delivers them to the user area, where the requester is responsible
for their storage and use. On demand requests can be made on a
regularly scheduled basis or as the need ariseshence the name
demand. While most healthcare facilities have used some form of
the demand system at one time or another, it is not the most
efficient method and relies heavily on the end users having the
time to closely manage inventory. End users are often comfortable
with this method because it is easy to use and they are familiar
with it, but it takes away from the time they have to devote to
patient care. It is the method of choice for rare or seldom used
items.

Exchange Cart Distribution
The exchange cart system is also
based on preset supply levels.
Supplies are placed in a cart that is
stored in the user area. An identical
cart is stocked and maintained in the
SPD area. On a regular basis, the SPD
technician exchanges the stocked cart
from the SPD area for the one in the
user area, ensuring that adequate supplies are always on hand.
Exchange carts are the method-of-choice for high inventory
turnover areas such as O.R.s and ICUs. While the system is
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The contents of this manual are the sole property of the Department of Veterans Affairs and may not be
used or reproduced without permission. convenient and easy to manage, there are additional costs
associated with creating and maintaining duplicate carts.

Case Cart Distribution
In the case cart system, a cart is stocked with all the supplies
needed for a specific surgical procedure or case. At the completion
of the surgery, all contaminated reusable devices are placed in the
cart. The cart is retrieved by SPD personnel and taken to the
decontamination area for reprocessing. This enhances infection
control by minimizing the chance of cross contamination.

The supplies and instruments for the case cart system may be
provided by different methods, such as procedure cards,
requisition forms, or computer printouts. With the computer
assisted approach, each surgery is assigned a case number. Based
on the surgery schedule for the day, an SPD computer operator
generates a supply list for each case. An SPD technician pulls the
required supplies and places them in a case cart. The stocked case
cart is delivered to the operating room prior to the scheduled
surgery time.

Specialty Cart Distribution
Specialty carts are carts that contain
supplies needed in emergency or special
situations. They must be solid or
impervious covered and have a solid
bottom shelf. After a specialty cart has
been used, it must be returned to the
receiving area and unused supplies
removed, prior to taking the cart into the
decontamination area for cleaning.

They include:
Disaster carts, which are stocked with medical supplies
needed for use in a sudden community misfortune, such as a
large traffic accident, bombing, or flood. This requires a cart
that can be easily transported to the scene of the disaster,
whether it is internal to the medical center or outside in the
community (external).
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The contents of this manual are the sole property of the Department of Veterans Affairs and may not be
used or reproduced without permission.

Implant carts, which are carts stocked with implants, such
as intraocular lens, vascular grafts, and knee and hip
prostheses that are transported to the operating room at the
time of the specific surgery.
Crash/Code carts, which are specialty carts that are used in
emergency situations to revive victims from respiratory
failure or cardiac arrest. SPD stocks the medical supplies and
the pharmacy stocks the drugs and intravenous solutions.
Crash carts are kept throughout the medical facility in order
to be available when needed and they must be locked with a
tamper proof lock. A list of all supplies and drug expiration
dates must be posted on the outside of the cart. These carts
should be inspected daily to ensure the security of the cart
and exterior supplies and equipment.
Special procedure carts, as the name implies, are carts that
contain supplies and equipment required for performing
specific procedures. They include arterial line carts, central
line carts, Swanz Ganz carts, urology carts, and suture carts.
Specialty carts provide a means to be immediately
responsive in time-critical situations. Keeping track of the
cart