GERM-FREE GUIDANCE
3 critical do’s and don’ts for handling sterile packaging
by Michele DeMeo, with Contributors: Stephen Kovach, Sue Klacik, Jane Severin, Jon Wilder T
hree critical practices can ensure sterile goods are delivered to the point of use undamaged, sterile, and safe for patient use. These practices are not exhaustive but provide a guideline in these changing times with rapidly emerging new viruses and other pathogens. While they may seem to be common sense, we have found that the best way to ensure something is understood is by repeating it. Why? New people come into the perioperative, material management, and sterile processing professions who need to learn. Sometimes “we’ve always done it this way may not be the best way.” Note: Always follow the CDC’s guidelines for handwashing.
1. Using proper hand hygiene • Properly perform hand hygiene after breaking down any external cardboard shipping boxes or other external shipping containment devices.
• At the start and close of each shift, at a bare minimum, disinfect the assembly worksta- tion or worktable with an EPA-registered surface disinfectant adhering to the proce- dure in its instructions for use (IFU). • Properly perform hand hygiene before preparing or handling items in sterile packaging.
• Always make sure your hands are com- pletely dry before handling items in sterile packaging.
• Do not eat or drink after washing your hands or handling (or packaging) items in sterile packaging.
2. Storing, transferring sterile goods • Check and ensure that any storage area for sterile goods has been properly cleaned according to each State’s infection control regulations as provided by their Health and Human Services Department and meets the recommendations of AAMI ST79:2017 Section 11.1: Sterile Storage.
otate sterile items from fi rstin to fi rst out“ by placing the newest items towards the storage bin area’s back. Reducing the risk of contamination is achieved through minimal handling.
• Do not transport sterile items on a dirty cart or store them with used or contami- nated items.
• Do not store items in sterile packaging under sinks.
• Transport sterile items in a manner that will prevent the package from puncture or contamination from moisture, excessive humidity, condensation, insects, vermin, dust and dirt, and excessive pressure. Included in this list are:
• not overcrowding bins or cabinets, • not using rubber bands or clips to bind items together or hang them to fi t them all in.”
These practices may damage or destroy the sterile barrier.
• Refer to the product’s IFU for storage conditions. Exposing some items to light or UV sources should not be allowed. Also, wiping packages with disinfectants should not be permitted. Otherwise, contaminants may get into the sterile container and render the item non-sterile or create toxic residues.
• Just before storing items, take an addi- tional look and inspect the item and packaging for any signs of compromise such as, but not limited to:
° staining on the packaging, ° proof of sterility, ° worn areas, ° tears - regardless of size,
• Do not put sterile packages in pockets, hold them with your mouth, or carry them outside the facility or staff break areas.
• Assume an item is contaminated if it is dropped on the fl oor or an unclean sur face. Do not use it.
3. Handling, opening sterile goods • Ensure your transfer cart, bin, or other device has been properly disinfected before placing items ready to be trans- ferred.
° If there is any question about disin- fecting your transfer cart, refer to the
disinfectant’s IFU before disinfecting. • Properly perform hand hygiene before you touch the package and transfer sterile goods to their secondary and/or fi nal storage staging area and before the point of use. • Re-perform hand hygiene should you inadvertently contaminate your hands, including touching your face or poten- tially soiled surface in the process of moving and transferring sterile goods.
° improper packaging (wrong type, wrong method of wrapping or containment, wrong type of packaging or contain- ment device for sterilization modality and kind).
Note: Performing these sterile inspection cri- teria should occur before items are issued from the last release point; Sterile Processing & Distribution (SPD) for in-house processing, or Materials Management (MM), Shipping and Receiving, etc.
• Return transfer cart, bin, or other devices to SPD, MM, or other designated depart- ment origin or area for subsequent clean- ing and disinfection after items are issued. • Return any compromised sterile goods for processing and return to the vendor or other response prescribed by facility policy.
• Properly perform hand hygiene at the end of this fi nal task and before entry into your next assignment area.
• Thoroughly inspect the package. Take one last look and inspect the item and packaging for any signs of compromise, such as but not limited to the following: staining or watermarks on the packag- ing, proof of sterility, worn areas, tears- regardless of size, improper packaging (wrong type, wrong method of wrapping or containment), expiration date. • Re-perform hand hygiene properly. The above three steps will help maintain
the integrity of the sterile barrier of prod- ucts within your facility to better ensure safe use. Failure in any of the above steps and tips present risks that may create a host of scenarios, but by far, the most impor- tant is the potential spread and transfer of pathogenic organisms. These simple reminders serve to highlight how relatively simple it can be to keep sterile goods sterile and safe for all when these principles are consistently applied. HPN
Michelle DeMeo,CPSDT, CRCST is an inde- pendent consultant and retired HPN Editorial Advisory Board member.
hpnonline.com • HEALTHCARE PURCHASING NEWS • May 2021 31
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