article · Frontiers in Public Health
Poorly maintained surgical tools compromise patient safety and prolong operations, an issue frequently encountered in low- and middle-income countries. To address these challenges, Nigeria implemented the Surgical Instruments Repair Technicians programme across its six geopolitical zones. The initiative combined online theory and hands-on repair training for biomedical technicians and sterile supply nurses from public and partner hospitals. Participants received specialised repair kits to set up dedicated institutional workbenches. Across two implementation phases, 36 personnel completed the training and assessed 1,623 surgical instruments, achieving a 99.6 percent repair success rate. Half of the participating facilities successfully established permanent repair workbenches and conducted maintenance drives for neighbouring hospitals. Trainees reported marked improvements in identifying damaged equipment and applying practical refurbishment skills, demonstrating an effective approach to enhancing operating theatre efficiency and equipment longevity.
Damaged surgical tools raise the risk of medical complications and delay operations. By training local biomedical technicians and nurses to repair instruments on site, hospitals can maintain essential healthcare tools without relying on costly replacements or distant technical support. This approach improves patient safety and keeps operating rooms running smoothly in resource-constrained health systems.
This model represents an applied and tested capacity-building solution ready for deployment across hospitals and health ministries in low- and middle-income regions. It offers an operational template combining specialised repair kits and training curricula that healthcare providers, development organisations, or technical training enterprises could adopt. Securing institutional budget integration represents the main step required for wider scaling.
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Background: Faulty or poorly maintained surgical instruments increase risks of complications, prolong operating times, and reduce efficiency, especially in low- and middle-income countries (LMICs). To address this, Nigeria introduced the Surgical Instruments Repair Technicians (SIRT) program, to improve instrument safety. Objective: This study evaluated the SIRT program's initial impact, sustainability, and scalability for improved surgical instrument maintenance in LMICs. Methods: The program was deployed in two phases. Phase one involved online theoretical and hands-on training for biomedical technicians and operating room/central sterile supply department nurses from Smile Train partner and public hospitals across Nigeria's six geopolitical zones. Participants were provided repair kits to establish institutional workbenches. Phase two focused on expanding training with a one-week hands-on program. Data on demographics, training feedback, and repair outcomes were collected. Results: A total of 36 participants completed training (24 in phase one, 12 in phase two), evaluating 1,623 instruments with a 99.6% successful repair rate. Post-training surveys showed that 83.3% of participants felt more confident identifying faulty instruments, and 95.8% reported adequate repair skills. Institutional workbenches were established in 50% of hospitals, and repair drives were conducted within institutions and neighboring hospitals. Conclusion: The program demonstrated significant potential for improving surgical instrument maintenance and enhancing safety in LMICs. Integrating the program into hospital budgets could support sustainable expansion.
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DOI: 10.3389/fpubh.2025.1522315
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