No matter what section of the perioperative loop you are in, ensuring that your sterile instruments are properly protected against impurities is a must. And when used correctly, rigid sterilization containers can offer an increased level of protection against those impurities and possible contamination than blue wrap and tape can. Now, that might sound like common sense, but, as Susan Klacik reported in a recent article in Outpatient Surgery, she’s seen many dirty and dented rigid containers in use in facilities around the United States, even in some of the most reputable ones.
So if you’re opting for rigid sterilization containers to protect your surgical assets, follow these six steps to ensure that those containers are actually equipped to fully and properly protect your instruments.
1. Test Your Containers Thoroughly
When you’re figuring out which containers to buy for your facility, request a few sample ones from the vendors you’re working with to test compatibility with your sterilization method. Before you test the samples, ask the vendor to identify areas of the container that are most resistant to sterilization. Once you receive the samples, you’ll want to place both BI tests and class 5 chemical indicators in those areas to see if your sterilization process effectively reaches all of those places.
Following the test, compare the results of the different containers you tested out in sterilization and choose the one that is most compatible with your process. And remember, even after you purchase your containers, you will want to continue this testing process at least once a year to ensure that your containers are still compatible.
2. Ensure Thorough and Correct Cleaning
No matter if a container was opened or not in the OR, when it is returned to the SPD, it must be cleaned and sterilized thoroughly again. Too many technicians assume that if a container was unopened and removed from a room before a patient arrived, it can be sent out for use again without being cleaned and sterilized. This is not the case. Ensure that your technicians are cleaning each container that returns to decontamination, regardless of its use.
Manufacturer’s instructions for use should also be followed at all times when cleaning your rigid containers to determine whether manual cleaning, mechanical cleaning, or a combination of both is required. These instructions will also outline disassembly instructions, the type of cleaning cloths that can be used, the kind of detergent to use, and more to ensure that your containers are cleaned properly without incurring any damage.
3. Assemble According to Instructions
Every rigid container comes with instructions for which instruments it was designed to carry. Refer to the instructions to determine whether or not it can hold items like lumened instruments, absorbent materials (like towels), loaner instruments, and ringed instruments so you can avoid paring assets with containers that aren’t equipped to handle those items.
4. Conduct Inspection of Containers
Before starting a sterilization cycle, carefully inspect your containers to identify nicks, cracks, or warping. Even dents can prove to be deadly as they pose just as big of a threat to patient safety as torn blue wrap; just because you can close a container doesn’t mean it’s safe.
Also make sure to check the pliability of the container's gaskets and the snugness of the filter-holding mechanism as issues in either one of these can inhibit proper sterilization. It’s better to spot integrity issues in a container before it enters sterilization than to take a gamble on patient safety.
5. Handle Containers Carefully During and After Sterilization
As you’re loading up your sterilizer, make sure you stack containers evenly and never directly on top of each other; there should be adequate space between each one to reach your hand through. Also make sure you never place a container above any kind of wrapped instruments to avoid any possible condensation that might form during the process from dripping onto the wrapped items. If you’re ever unsure of whether or not you’re loading a sterilizer correctly, refer to instructions for use to gain further direction.
6. Store Containers Appropriately
Following sterilization, ensure proper storage of the assets by following this general rule: store containers in a sterile environment at least 8 to 20 inches from the floor and at least 18 inches below any sprinkler head. You can stack containers in storage environment but avoid stacking more than a couple on top of each other. Additionally, to ensure that your containers are in good working condition throughout the entire perioperative loop, instruct the OR staff to inspect containers upon their arrival in the OR. If anything looks out of place, dented, etc., containers should be promptly sent back to SPD.
When used, inspected, sterilized, and stored properly, rigid containers have the ability to offer your facility full protection against contamination while keeping your assets free from impurities. Equip and educate your staff to follow these six steps in the SPD every day to boost protection and increase patient safety.
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ANSI/AAMI ST79, Comprehensive guide to steam sterilization and sterility assurance in health care facilities. 2017
AST Guidelines for Best Practices for Laundering Scrub Attire. April 14, 2017. https://www.ast.org/uploadedFiles/Main_Site/Content/About_Us/Standard%20Laundering%20Scrub%20Attire.pdf
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Role of healthcare apparel and other healthcare textiles in the transmission of pathogens: a review of the literature. March 31, 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132459/
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