Sterile Items Research Articles

Analysis of Infection Prevention Control Management of Central Sterile Supply Department (CSSD) Staff

Background: The Central Sterilization Supply Department’s (CSSD) main function is to clean, disinfect and provide sterile items for subsequent use by healthcare professionals in various hospital departments, including the ambulance. Materials and Methods: A survey of infection prevention control (IPC) knowledge, practice, and infrastructure adherence was conducted in a selected government super-speciality hospital's central sterilisation supply department (CSSD). The data were analysed, and a report with recommendations was presented to the institution's head. Results: The overall response showed good knowledge and practices with hospital environmental adherence to infection prevention control protocol with few infrastructure modifications facilitating the unidirectional flow pattern. Conclusion: This study was able to bring insights into the staff knowledge and practice towards IPC adherence

ANTT® standardisation facilitates new efficiencies with a novel partially-sterile Standard-ANTT PIVC Pack

Partially-sterile procedure pack - all items required to be sterile remain in their individual blister wrapper. The final assembled pack itself is not then subjected to a further round of sterilisation as it is not needed. Sterile procedure pack - often contains a mixture of non-sterile and sterile items that have been stripped from their individual blister wrapper requiring the sterilisation of the final assembled pack.

The Supervision and Management Mode of Disinfection Supply Center Improves the Standardization of Sterile Goods Management in Clinical Departments.

Background In daily inspection, the nonstandard management of sterile articles in clinical departments of hospitals often leads to the destruction of the sterilization effectiveness of sterile articles. Therefore, it is necessary to strengthen governance and improve this phenomenon. This study intends to investigate the mode in which the disinfection supply center participates in the supervision and management of the management of sterile items in clinical departments. It played a role in improving the standardization of the management of sterile articles in clinical departments and ensured the closed-loop management of the sterilization effectiveness of sterile articles. Methods Every quarter, the disinfection supply center of our hospital will inspect the standardized management of sterile articles in all clinical departments of the hospital, mainly including the storage environment and facilities of sterile articles, the cleanliness of storage cabinets, placement principles, whether they are stored by category, and the quality and validity management of sterile articles. The quarterly inspection results were summarized and analyzed to find the existing problems and the causes. The disinfection supply center shall supervise the improvement. After the disinfection supply center inspected the standardized management of sterile articles in all clinical departments of the hospital for the first time according to the inspection contents, under the guidance and assistance of the nursing department and the hospital infection department, it improved the sterile article management system, conducted knowledge training for the whole hospital, and incorporated the standardized management of clinical sterile articles into the quality control inspection of the nursing department. In the later stage, the disinfection supply center is responsible for conducting routine inspection and supervision on the standardized management of sterile articles in all clinical departments of the hospital every quarter according to the inspection contents, including summarizing, analyzing, and urging the clinical departments to achieve the improvement of the management of sterile articles in clinical departments. Results The standardization of aseptic articles after improvement was significantly higher than before and during improvement, and the qualified rate was significantly different (99.4% vs 97.9% vs 89.5%, P < 0.05). The average number of lost packages caused by nonstandard management in the department was significantly reduced. The average rate of lost sterile packages during and after the improvement was significantly lower than that before the improvement (10.5% vs 97.9% vs 89.5%, P < 0.05). It also effectively reduced the cost caused by the loss of sterile packages. Conclusion The disinfection supply center participates in the quality control and management of sterile articles in the nursing department and regularly inspects and supervises the management of sterile articles in clinical departments. It can effectively improve the standardized management of sterile articles in clinical departments, ensure the safety of sterile articles, and form a closed loop of sterilization effectiveness.

Evaluation of the Effect of PDCA in Hospital Health Management.

PDCA plays a very important role in the hygienic management of hospital operating rooms. Before the PDCA management from February 2018 to February 2019, routine hygiene management in the operating room was adopted; after the PDCA management from February 2018 to February 2019, PDCA cycle management was adopted. 500 surgical patients were randomly selected from both groups. We compare the quality control checklist scores of hand hygiene management, environmental hygiene management, medical waste management, and disinfection and isolation management in the routine group and the PDCA group. We also compared the detection rate of pathogenic bacteria in surgical incisions of the routine group and the PDCA group and the infection rate of various surgical incisions, air samples, surface samples, disinfectants, and sterilization rates of sterile items. The PDCA group's hand hygiene management score, environmental hygiene management score, medical waste management score, and disinfection and isolation management score were higher than those in the conventional group (P < 0.05). The detection rate of pathogenic bacteria in the PDCA group, the infection rate of type I, type II, and type III incisions, and the total infection rate of surgical incisions were lower than those in the conventional group, and the difference was statistically significant (P < 0.05). The qualified rate of air samples and surface samples in the PDCA group was higher than that in the conventional group (P < 0.05), and the difference in the qualified rate of disinfectants and sterile items between the two groups was not statistically significant (P > 0.05). The hygiene management of the operating room adopts PDCA sustainable improvement management measures to effectively increase the qualification rate of disinfection and sterilization, reduce the detection rate of pathogenic bacteria and infection rate of surgical incisions, and strengthen the management quality of hand hygiene, environmental hygiene, medical waste, and disinfection and isolation.

Influence of Washing and Sterilization on Properties of Polyurethane Coated Fabrics Used in Surgery and for Wrapping Sterile Items.

The objective of this work was to determine the influence of washing and sterilization under real hospital conditions on properties of microbial barrier offered by polyurethane coated fabrics used in surgery and for wrapping sterile items. Emphasis was put on the change of surface polyurethane coating by using FTIR analysis. The permeability and durability of the microbial barrier were determined after 0, 10, and 20 washing and sterilization procedures according to previously developed methods. Bacterial endospores of the apathogenic species of the genus Bacillus Geobacillus stearothermophilus and Bacillus atrophaeus were used. Mechanical damage to medical textiles in the washing and sterilization process was determined according to standard HRN EN ISO 13914-1:2008 and associated with changes in physical and mechanical properties. Chemical changes of PU coatings were determined using FTIR analysis. The results showed an exceptionally efficient microbial barrier and its durability in all samples after 0, 10 and 20 washing and sterilization procedures and for a period of one, two and three months.

Analysis on the effect of color management in the management of aseptic articles in operating room

Objective To explore the application of color management method in the management of aseptic articles in operating room. Methods From November 2016 to October 2017, based on the color system management method, the term of validity of sterile items in the operating room of the hospital was managed in an orderly way. According to the signs of red, yellow, blue and green, the expiration year and month were distinguished and pasted into sterile items. Staffs in the department were familiar with the meanings of signs of various colors.Before and after the implementation of the sterile items inspection time, the incidence of sterile items expired events and the satisfaction of the medical staffs were observed and compared. Results After the implementation of color management method, the average inspection time of aseptic items and the incidence rate of aseptic items were significantly reduced, with statistically significant differences (P<0.001). The satisfaction of medical workers on the management of sterile items in the operating room was significantly increased, and the difference was statistically significant (P<0.001). Conclusions In the management of aseptic items in the operating room, color management is an efficient and feasible management method, which is worthy of clinical application. Key words: Operating room; Color management; Sterile goods; Nursing management

Proper indwelling catheter use to prevent CAUTIs

Proper indwelling catheter use to prevent CAUTIs

Guideline Implementation: Sterile Technique

Establishing and maintaining a sterile field to help prevent surgical site infections requires specific knowledge and skills and is among the most important responsibilities of the perioperative RN. Perioperative RNs should remain vigilant in monitoring the sterile field, communicate when a break in sterile technique occurs, and collaborate with other surgical team members to correct the break in technique. The AORN "Guideline for sterile technique" provides guidance to perioperative personnel on the principles and processes of sterile technique. This article elaborates on key takeaways from the guideline, including using sterile technique when donning sterile gowns and gloves, delivering sterile items to the sterile field, using drapes to establish a sterile field, and maintaining the sterile field. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

Guideline Implementation: Sterilization.

Ensuring that reusable surgical instruments and medical devices have been sterilized is an important factor in preventing surgical site infections. The sterilization method for a particular device is based on the device design, material, packaging, compatibility with the sterilant, load limitations, and safety requirements. Perioperative team members must review the manufacturer's instructions for cleaning, packaging, and sterilizing the device to determine the correct sterilization process. The AORN "Guideline for sterilization" provides guidance for processing reusable medical devices for use in perioperative and procedural settings. This article elaborates on key takeaways from the guideline, including processing a device based on the intended use of the item, protecting sterile items during transport, reprocessing by immediate-use steam sterilization when certain conditions can be met, and educating personnel who perform sterile processing activities. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

Influence of special management team on supply quality of disinfection supply center and satisfaction of other departments

Objective To explore the impact of the establishment of special management team on the supply quality of disinfection supply center and satisfaction of other departments. Methods A total of 1 000 cases of sterilization packages were selected after the establishment of special management team in the disinfection supply center in this hospital from January to December 2016, and were compared with 1 000 cases of sterilization and sterilization kits without special management group from January to December 2015.The disinfection and sterilization quality before and after the implementation of special management team was analyzed.The satisfaction questionnaire was designed by the participants.100 medical staffs were randomly selected to participate in the satisfaction survey.The satisfaction before and after the implementation of the special management team. Results After carrying out the special management group, the equipment cleaning, packaging, sterilization, and goods distribution qualified rate were significantly higher than before implementation, and the differences were statistically significant(P<0.05). After the work of the special management team, the clinical department showed significantly higher satisfaction with service attitude, recycling and sending, business processing and sterile items, and the differences were statistically significant(P<0.05). The incidence of nosocomial infection in surgical department and non-surgical department was significantly lower after the establishment of special management group, and the difference was statistically significant(P<0.05). Conclusion The establishment of special management team is conducive to improving the quality of disinfection and sterilization, improving the satisfaction degree of clinical departments, effectively preventing nosocomial infection and ensuring the quality of medical treatment.It is worthy of promotion and application. Key words: Specific management team; Disinfection supply center; Supply quality; Degree of satisfaction

Influencing factors of valid period of sterile items

Objective To investigate the related factors that affect the valid period of sterile items. Methods Sterile items after well cleaning and disinfection were stored in the supply room with a standard storage conditions, as well as in different storage conditions such as neural therapy room, general surgery dressing room, outpatient and emergency injection room, clean operating room with 120 items respectively. Bacterial culture was performed regularly on the sterile items in different storage rooms. Results At 90 d after sterilization, 3 sterile items stored in the outpatient and emergency injection room with paper-plastic packaging had the bacterial growth. At 105 d after sterilization, 2 samples in the general surgery dressing room with paper-plastic packaging were found to have the bacterial growth. At 150 d after sterilization, 1 sample in the general surgery dressing room with non-woven packaging had the bacterial growth. Up to the end of the experiment, no bacterial growth was observed in the sterile items stored in disinfection supply center, neural therapy room and clean operating room. Conclusions The factors that affect the valid period of the sterilized items are related to the time. It is necessary to evaluate influencing factors of the valid period of sterile items from various perspectives. Specification, industry standards and provision should be executed to ensure the quality of the sterilized items and prevent nosocomial infection. Key words: Disposable packaging material; Sterilized items; Valid period; Influencing factor

The efficacy of meticulous process management in control of infections in operating room

Objective To discuss the nursing effect and application value of refinement process of nursing management mode in hospital infection control in the operating room. Methods 620 patients who will carry out surgical treatment were selected as the research subjects.310 cases without detailed process of nursing management were included in the control group, and 310 patients with refinement process of nursing management were selected as observation group.The clinical nursing effects of two groups were recorded. Results Observation group surface 88.94%, medical staff hand 92.54%, disinfectant 95.65%, 100.00% sterile items.The control surface 81.38%, 80.00% of medical personnel hand, disinfectant 75.93%, 90.00% sterile items, the monitoring qualified rate between two groups had statistically significant differences (χ2=5.021, 4.596, 7.581, 6.725, all P<0.05). The sores of nursing safety, operating room management, form filling, ward nursing in the observation group were (95.37±4.66)points, (94.27±5.21)points, (96.13±3.29)points, (95.03±4.87)points.Those in control group were (90.12±2.03)points, (89.13±2.26)points, (90.03±1.88)points, (88.17±2.25)points, the differences between two groups were statistically significant (t=18.185, 15.935, 28.343, 22.514, all P<0.05). The scores of nurses and patients communication, nursing procedures, ward environment, care attitude in the observation group were (24.19±0.87)points, (24.03±0.64)points, (24.51±0.45)points, (24.28±0.36)points.Those in the control group were (21.54±1.65)points, (20.88±1.72)points, (20.95±1.66)points, (21.09±0.89)points, the differences between two groups were statistically significant (t=25.013, 30.220, 36.443, 58.502, all P<0.05). Conclusion Refinement process of nursing management mode application helps to control nosocomial infection in operating room of hospital infection control, improve the quality of clinical nursing services, improve the clinical nursing satisfaction, which is worthy of popularization and application in clinic. Key words: Meticulous process management; Operating room; Infection control

Comparison of Sterile and Clean Dressing Techniques in Post-operative Surgical Wound Infection in a Chinese Healthcare Facility

Purpose: To investigate the effect of sterile and clean dressing techniques on wound management in a Chinese hospital, and to compare their impact on wound healing and the cost of the dressing materials with respect to postoperative surgical wounds.Methods: A total of 130 patients, comprising 70 (53.8 %) males and 60 (46.2 %) females, who had undergone surgery in The Affiliated Hospital of Changchun Traditional Chinese Medicine University, Changchun, China in 2012 – 2014 were enrolled in the study. Of these, 65 (50 %) received sterile dressings and 65 (50 %) clean dressings. A control group comprising 25 patients, 15 (60 %) males and 10 (40 %) females, who attended the clinic for change dressings only, was also included. The patients’ dressings were changed four times daily with 2x sterile and 2x clean dressings. Details of all the changes, including the nutritional status of the patients, were recorded. The patients were followed-up up to the time of their discharge.Results: Twelve (18.5 %) patients out of those who received sterile or clean dressings were found to have acquired an infection. The size of the wounds was approximately 1.8 to 32.4 cm3 (mean: 5.2 ± 6.4 cm3) in size at the start of the study and 0.6 to 4.2 cm3 at the end of the study. A significant difference was identified between the sterile and clean dressing groups at the beginning of the study (U = 72.5; p &lt; 0.12). A decrease in wound size was observed in both of these groups but was not statistically significant, while the change in wound volume, was significantly different (U = 84.5; p &lt; 0.25). When the cost of the two dressing types was compared, the sterile items were more expensive than that of the clean items; thus, sterile dressing procedure was significantly more costly than clean dressing procedure (p &lt; 0.01).Conclusion: With mounting concern regarding antimicrobial resistance and hospital-acquired infections, suitable wound dressing techniques are required to prevent infection and reduce the duration of wound healing after surgery without compromising patient safety.Keywords: Wound dressing, Postoperative, Antimicrobial resistance, Hospital acquired infections

Implementing AORN Recommended Practices for Selection and Use of Packaging Systems for Sterilization

The delivery of sterile products to the sterile field is essential to perioperative practice. The use of protective packaging for sterilized items is crucial to helping ensure that patients receive sterile items for surgical procedures. AORN’s “Recommended practices for selection and use of packaging systems for sterilization” offers guidance to perioperative team members in evaluating, selecting, and using packaging systems that permit sterilization of the contents, prevent contamination of sterilized items until the package is opened for use, protect the items from damage during transport and storage, and permit aseptic delivery of the items to the sterile field.

Operative coordination in one case of Intracranial hematoma removal combined with resection of spleen surgery

Objective : the authors summarized the operative coordination means which operated on the the same patients with Intracranial hematoma removal combined with resection of spleen surgery at the same time. Methods: From the perspectives of preoperotive preparation, hand-washing nurses and visiting nurse respectively, the paper elaborated the placement of sterile towels, personnel reasonable stance, the check and management of sterile items, etc. Results: The surgery was finished smoothly. Conclusion: To assist the surgery is a comprehensive test for nurses’ ability at the operating room. The work responsibility should be clearly arranged, and the principle of intraoperative sterile operation should be strictly followed.

Effects of infection control rounds on the the quality of infection management in ICU ward

Objective To understanding the implementation of ICU infection control measures and the effect of ICU infection control measures on hospital infection control,in order to take effective control measures to reduce the occurrence of hospital infection.Methods The infection control personnel inspected the implementation of ICU infection control measures 2 times per week.The results of clinical rounds were discussed and analyzed,the rectifcation measures were formulated,and the rectification results feedback.Results The rates of correct and compliance on hand hygiene were respectively 79.2％,51.6％ after rounds,and were higher than 58.5％,30.3％ before rounds,and the differences were statistically significant (x2 =10.65,50.24,respectively; P ＜ 0.05).The incidence rates of ventilator associated pneumonia (VAP),arteriovenous catheter-related bloodstream infection (CRBSI) and urethral catheter-related urinary tract infection (CAUTI)were respectively17.1％,2.4％,1.1％ after rounds,and were lower than 30.2％,4.8％,2.5％ before rounds,and the differences were statistically significant (x2 =4.08,0.42,4.06,respectively; P ＜ 0.05).The qualified rates of infection control indicators including enviroumental health management,sterile technical operation,disposable sterile items management and medical waste management were respectively 94.3％,96.2％,95.2％,91.4％ after rounds,and was significantly higher than 80.9％,72.3％,79.1％,68.6％before rounds,and the differences were statistically significant (x2 =7.42,20.71,10.88,15.74,respectively; P ＜ 0.05).The rectification rate of infection control measures problems was 95.4％ in 2012,and was significantly higher than 77.8％ in 2011.Conclusions Infection control rounds can improve subjective initiative and the bidirectional interaction in infection monitoring personnel,ICU physicians and nurses,improve the execution rate of prevention and control measures,and improve the quality of infection control. Key words: Infection control; Rounds; ICU; Infection management

Shelf life of sterilized packaged items stored in acute care hospital settings: factors for consideration

Reusable medical devices are sterilized and stored before their use in hospital settings. The length of time the sterilized item can be stored (shelf life) to maintain sterility has been discussed in the literature over the last four decades, with a shift to an event rather than time-related determination of shelf life. This paper reviews the evidence and provides a summary of some key issues for consideration when adopting event-related or time-based shelf life recommendations for packaged sterile items in Australian hospitals. Australian and international standards provide guidelines for procedures to be used for sterilization of reusable medical devices and storage conditions following sterilization. Reusable medical devices are sterilized by commercial manufacturers or sterilizing departments located in hospitals. Commercial manufacturers allocate expiry dates on sterilized items which should be respected, unless sterility is compromised by an event. The shelf life of items sterilized in hospital is debated, with growing support for event- rather than time-related sterility. Many factors determine whether event- or time-related shelf life should be followed. Well designed experimental studies into shelf life of sterilized items are lacking, with some small studies indicating that items can remain sterile for 12 to 24 months. Factors for consideration by hospitals are outlined and an algorithm to assist in implementation of event-related or time-based shelf life for reprocessed reusable medical devices is provided. The method of determining shelf life in hospitals is dependent on adequacy of processes for sterilization, monitoring of sterility over time and storage conditions.

Saving Costs through the Decontamination of the Packaging of Unused Medical Supplies Using Hydrogen Peroxide Vapor

OBJECTIVE. Individually packaged sterile supply items may become contaminated and act as vectors for nosocomial transmission of multidrug-resistant organisms (MDROs). Thus, many hospitals have a policy to dispose of these unused, packaged supply items at patient discharge from the hospital, which has considerable cost implications. We evaluated the frequency of contamination of these items, the efficacy of hydrogen peroxide vapor (HPV) in disinfecting them, and costs associated with discarded supplies. DESIGN. Before-after study. METHODS. A pilot study was performed in the rooms of 20 patients known to be colonized or infected with vancomycin-resistant enterococci (VRE), and a follow-up study was performed in an additional 20 rooms of patients under precautions for various MDROs in 6 high-risk units. Five pairs of supply items were selected. One item of each pair was sampled without exposure to HPV, and the other was sampled after HPV exposure. The cost of discarded supplies was calculated by examining stock lists of supplies stored on the study units. RESULTS. Seven (7%) of 100 items were contaminated with VRE in the pilot study, and 9 (9%) of 100 items were contaminated with MDROs in the follow-up study. None of the items were contaminated after exposure to HPV (P < .02 in both the pilot and the follow-up study). The annual cost of supplies discarded at patient hospital discharge was $387,055. This figure does not include the cost of waste disposal and is therefore likely to be an underestimation of the financial burden. CONCLUSIONS. HPV effectively disinfected the packaging of supply items, which could generate considerable financial and environmental benefits.

Clinical Issues—March 2011

This MonthFirst surgical hand scrub of the dayKey words: alcohol‐based surgical hand rub products, surgical hand antisepsis, standardized surgical hand rub protocol.The correct method for sterilizing towel clipsKey words: ratcheted instruments, instrument hinges, bloodborne pathogens standard, glove tears, percutaneous punctures, instrument stringers.Patient abandonmentKey words: patient abandonment, patient assignment, nurse‐patient relationship.Determining shelf lifeKey words: event‐related sterility, expiration dates, moisture‐controlled environment, dust‐controlled environment, storage conditions, sterile storage, shelf life, sterile items.

A Day in the Life of a Central Processing Technician

A Day in the Life of a Central Processing Technician