Issue link: https://beckershealthcare.uberflip.com/i/824946
42 Executive Briefing Sponsored by: Scratching Below the Surface: How Taking a Closer Look at Your Sterilization Packaging Systems Can Increase Patient Safety T he sterile processing department used to be a lit- tle-known department in the hospital, relegated to the basement or tucked away in a not-oft-visited area of the hospital and ignored by quality improvement initiatives and ac- creditation organizations, according to Peg Luebbert, an infec- tion preventionist with Nebraska Orthopaedic Hospital. "[Leadership] always felt there were bigger fish to fry some- where else" in terms of infection control and prevention, says Ms. Luebbert, who also serves as the owner and a consultant at Healthcare Interventions, Inc., and is also paid by Halyard Health. However, that attitude is changing fast, in large part due to the endoscope-related bacterial outbreaks that plagued hospitals across the U.S. starting about five years ago. "When the out- breaks started … we recognized that we can decrease infec- tions related to instrumentation, [and] the sterile processing department was brought to the forefront," Ms. Luebbert says. Since then, hospitals and surgery centers have been hyper-fo- cused on properly reprocessing the difficult-to-clean reusable scopes, and for good reason. But the sterile processing depart- ment's role in preventing surgical site infections and health- care-associated infections goes beyond sterilizing and repro- cessing endoscopes and other instruments. This department is also responsible for assembling, packaging, sterilizing and storing sterile surgical trays between uses in the OR and other hospital departments. "I think one thing that people tend not to realize with SPD is how many dozens of steps are in the process — bringing dirty equipment from the OR, cleaning it and bringing it, clean, back to the OR," Ms. Luebbert says. Following best practices when sterilizing and reprocessing surgical tools is integral to patient and provider safety. Just as important is having a sterile packaging system in place to maintain sterility effectively up until the point of instrument use. However, recent studies of different sterile packaging methods found that not all packaging systems are created equal, and or- ganizations using rigid containers may unintentionally put their organizations at risk. For this reason, infection control leaders see an opportunity to substantially improve patient safety by reexamining and updat- ing their sterile packaging systems. The Importance of Sterile Packaging Systems Sterile packaging systems — i.e. wraps or rigid containers that protect sterile surgical trays — were put in the crosshairs in a December 2015 study published in the American Journal of Infection Control. For the study, researchers used aerosolized bacteria to test 111 rigid containers of varying ages and 161 wrapped trays with three grades of bonded sterilization wrap for bacterial ingress. None of the wrapped trays demonstrated bacterial ingress into the tray after the test, according to the study, while 97 of the 111 rigid containers (87 percent) showed bacterial ingress. Ad- ditionally, the study found a positive correlation between con- tamination rates of a rigid container and the container's age. "The study … brought to our attention, surprisingly, that there are concerns with some of our rigid containers being able to maintain that sterility," Ms. Luebbert says. "Most SPD people, as well as infection preventionists, were very surprised by the conclusions of that study." One reason the findings were surprising is because rigid containers have been used in hospitals for years, and ex- perts assumed they were maintaining sterility. "They looked tough and strong and were able to be moved easily," Ms. Luebbert says. "We thought we didn't have to be concerned with rigid containers." Consensus Statement The study in the American Journal of Infection Control spurred infection prevention advocates from multiple areas of the in- dustry — including Ms. Luebbert — to come together and pen a "Consensus Statement on Sterility Maintenance of Sterile Pack- aging Systems in the Hospital Setting." Halyard Health pub- lished the statement in July 2016. "When the study came out, we recognized that these were new and unexpected results for our SPD world," Ms. Luebbert explains. "We needed to put together a consensus statement "There are concerns with some of our rigid containers being able to maintain that sterility." — Peg Luebbert