AAMI News January 2018

Asked & Answered: Sterilized Instruments in Physician Office

With this edition of AAMI News, we introduce a new feature in which we showcase questions and answers from professionals participating in AAMI’s online discussion groups, collectively known as AAMI Connect. AAMI does not endorse specific practices or advice. Participants in these forums are sharing their own experiences and insights.

Q: We sterilize instruments for numerous gynecologic (GYN) physician offices that are part of our hospital system. When the instruments are sent back to the offices, some are opening the peel packs and placing the instruments (now unsterile but clean) into drawers for use. Is this a standard practice for physician offices?

A: Only if the instrument is being used for a nonsterile procedure. Sterile procedures require sterile instrumentation, regardless of the practice setting.

Beatrix Thom, director of clinical outcomes and infection prevention for the Florida-based Memorial Healthcare System

A: We follow manufacturer’s instructions. We sterilize in packaging and return it to the owner. I have a clear conscience knowing that I did my job correctly. If you have explained or given them the cleaning/sterilization instructions from the manufacturer, then they are making the wrong decisions. The Joint Commission (TJC) was in the area a few years ago, and they dinged some other facilities for similar situations. I went to my managers and explained that the instruments they were taking out of the packaging would be a problem. Most—if not all—have stopped doing that.

Kay Huston, lead sterile processing tech for Henry County Hospital in Napoleon, OH

A: We implemented a process change for our obstetrics (OB) offices that included packaging the peel pack. Peel packs were sometimes opened before they were needed. This process change saves supplies on our end and time on the OB offices’ end.’

Melissa Gillin, sterile processing manager for Texas Health Huguley Hospital in Burleson, TX

A: The purpose of peel packing and sterilizing the item is to ensure the cleanliness and sterility of theproduct. I have witnessed many private practices associated with large medical centers get cited by TJC for opening peel packs and emptying the items into a drawer. TJC will have issues with the separation of clean and dirty. The recommendation is to peel pack each item and store until used for patient care. This is recommended for all instrumentation, including speculums, anesthesia blades, etc.

Kevin M. Bush, Jr., director of sterile processing for the Penn State Health Milton S. Hershey Medical Center

A: Our GYN clinic would also get speculums from us in peel packs then open them and place several different sizes in a drawer. We now place several speculums in a large peel pack together, and then the bag is placed in the drawer so they can open the bag, get out a speculum, and the information is all there. I’d personally like to see them individually peel packed and not opened until time of use, but this is working for now.

Patricia Taylor, central sterile supervisor for Major Hospital in Shelbyville, IN

Do you have a question? Get answers from your peers on AAMI Connect, www.aami.org/connect.