How improving sterile supply management in the OR can reduce infections and readmissions

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[This content is sponsored by Surgical Directions]

Improving sterile supply management is one way hospitals can reduce the risk of infections and infection-related readmissions for their patients.

Hospitals and other healthcare facilities may have hundreds or thousands of different kinds of sterile products and implants in inventory— such as total joint implants, laparoscopic and open stapler devices, intraocular lens implants, disposable endomechanical devices, dressing, suture, needles, syringes, biological products and multiple other disposables — at any given time. Ensuring the integrity of these products is vital to preventing infections in patients and reducing readmissions.

Barbara McClenathan, RN, BSN, MBA, CNOR senior nurse specialist for perioperative consulting firm Surgical Directions, highlighted key concerns of ensuring product sterility: bioburden, product integrity, expiration, dust, debris, temperature and humidity.

"Bioburden is living, microbial load that may be a result of cross contamination or aerosolization and that may reside on the exterior of sterile disposable products," said Ms. McClenathan. "Managing sterile supplies to prevent bioburden contamination is extremely important to preventing infections."

There are three areas of supply management that hospitals and other healthcare facilities must focus on to ensure products remain sterile and free of contaminates, according to Ms. McClenathan. They include:

1. Manufacturer defined product sterility. There are two ways product sterility can be compromised, including:

2. Product storage. If a product is not stored appropriately, it may no longer be considered sterile. For instance, sterile products storage must follow manufacturer and regulatory agency recommendations. This includes being stored in a place at the right temperature, right humidity level, appropriate air flow direction and number of air exchanges per hour. Traffic should be limited and workers should be wearing the appropriate attire to be in sterile storage areas near supplies.

Ensuring appropriate sterile product shelving is also crucial. Shelves shouldn't be near windows, doors, sinks, vents or pipes, and bottom shelves should be covered to keep out dirt and dust. Additionally, sterile products should be immediately removed from outside shipping boxes that may be contaminated with debris, insects, fungi or bacteria.

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3. Cross-contamination in the OR. In the OR, products should be kept in a closed container during a surgical procedure and transported while covered to prevent aerosolized bioburden contamination. Nurses and OR staff should also be sure to check whether products can be dropped on the sterile field or must be opened by a circulating nurse and handed directly to the scrub technician.

"Compliance failures in any one of these three areas significantly increase the risk of infection and readmission for patients," said Ms. McClenathan.

Improving sterile supply management is a goal that staff at any level of the hospital can achieve.

For instance, hospital executives can:

Surgeons can:

OR staff members can:

Implementing tactics like the ones above takes time and is always challenging. It may be more difficult in smaller, stand-alone hospitals that are not part of a larger system, where surgeons or clinicians may threaten to leave if they find the rules disagreeable. In larger health systems there tends to be more tolerance of these necessary processes, according to Ms. McClenathan. Still, the goal of improving sterile supply management is an important one for all hospitals looking to reduce infections and readmission.

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