The following content is sponsored by Innovative Sterilization Technologies
Hospital's sterile processing departments play an under-the-radar yet critically important role in patient care. While their function may not be prominently known to patients, they are responsible for safely sterilizing and reprocessing medical and surgical supplies and equipment, and if they face obstacles outside their control that hamper their work, it can delay surgeries and even lead to infections and other forms of patient harm.
Like at many hospitals, the sterile processing department at Cincinnati Children's Hospital was facing some challenges. The hospital's sterile processing department had been dealing with problems associated with package integrity of wrapped trays and a time crunch associated with trays coming in from vendors, according to Matt Tewksbury, director of sterile processing and distribution at the hospital.
For instance, despite the best efforts of the department's staff, wrapped trays that had unique designs, like sharp corners, became contaminated. "There [would be] a hole in the tray and we have to process it again," Mr. Tewksbury explains. That problem can lead to delayed surgeries or hurried staff trying to turn over the trays in time for the next case, which can lead to more problems.
Surgeons at Cincinnati Children's also perform many procedures — especially spine surgeries — that require trays from vendors, according to Mr. Tewksbury. Sometimes, vendors deliver a set just hours before the surgery the trays are needed for, leaving the sterile processing department in a hurry to get everything ready and safe for the patient and surgical team.
"Sometimes they [the loaner trays] come in in a timely fashion, but sometimes they come a few hours before the case," Mr. Tewksbury says, which turns into a "hurry-up" situation in the sterile processing department to get them ready for the OR staff.
These two pain points became enough of a problem that Mr. Tewksbury and other Cincinnati Children's leaders decided to make one change that would address both issues: changing to One Tray for tray sterilization.
The One Tray system, which is 510(k) cleared by the U.S. Food and Drug Administration, is a rapid processing and sterilization system that involves a rigid container and proprietary filters. Most notably, the One Tray system requires no dry or cool time, cutting a lot of time out of the sterilization process. In fact, the system has been validated for zero minutes of minimum dry/cool time.
With the One Tray system, Cincinnati Children's sterile processing department now has "the ability to process a large number of trays in a small amount of time," Mr. Tewksbury explains. "We're cutting out a significant amount of sterilization time — the dry time," he says.
The One Tray system's rigid design also eliminates the package integrity issue completely, he says, because the trays are no longer being wrapped.
Cincinnati Children's has an adequate number of the trays in use currently. The hospital uses them mostly on loaner trays from vendors, to speed turnover. In a few instances, the sterile processing staff will use the system to sterilize trays that had package integrity concerns.
Effect on staff
Acquiring the One Tray system and using it effectively in a hospital takes change, and change isn't always easy. At Cincinnati Children's, making the switch successfully required educating staff members in the sterile processing department as well as in the operating room.
According to Mr. Tewksbury, the OR staff had been trained to expect a sterile tray to show up in the OR dry. But with the One Tray system, water or moisture can be found in sterile trays due to its unique technology and success at sterilizing instruments with zero dry time. The staff needed to be retrained for the new normal with One Tray.
"It took education and reinforcement for what to expect when using One Tray," he says.
With the help of the One Tray team, the education process started with presentations to large groups of OR staff members about what to expect with One Tray use. Then, since Cincinnati Children's uses the One Tray system most extensively with orthopedic cases, OR staff who work on orthopedic cases went through more extensive training in smaller groups that went into greater detail about the system, what to expect and how to use the tray. Some staff nurses, especially scrub nurses and technicians, received one-on-one training.
Mr. Tewksbury also recommends having someone from the sterile processing department in the OR for the first few cases to reinforce that what the OR staff is seeing — moisture in a sterile tray — is, in fact, normal.
Now that everyone knows what to expect, the staff has been very happy with the new process, according to Mr. Tewksbury. "I [recently] had a scrub nurse stop me and tell me how much she loved the One Tray" and that she trusts the system, he says. "Education was key in that, and constant reinforcement and involvement."
Surgeons at Cincinnati Children's are satisfied with the new system after gaining trust in it, Mr. Tewksbury says. "They have a higher degree of comfort now that the issue of package integrity has gone to the wayside," he says, and they like the fact that they are able to start cases on time with no defects in the integrity of the packaging of the trays.
Results
Mr. Tewksbury calls the One Tray system a "worthwhile investment," and that is true in more ways than one.
Not only will using One Tray result in fast, safe instrument turnover in the sterile processing department, it will also save hospitals money. Hospitals with service lines that do a lot of repetitive cases each day may not need to have a lot of backup instrumentation to keep pace with the day's cases, thus saving money. Additionally, hospitals no longer need to purchase as much sterilization wrap or tape, since the tray has a rigid design, which furthers the cost savings for hospitals.
Further, the quick sterilization time can limit sterile processing-related delays in the OR, which, according to industry averages, can cost anywhere from $75 to $200 each minute.
Mr. Tewksbury says he would "absolutely" encourage other hospital sterile processing departments to try the One Tray system in their sterile processing departments and ORs as ONE TRAY has exceeded all expectations.