August 25, 2022

Eliminating blue wrap from the reprocessing equation leads to greater efficiencies and improved instrument care.

Wrapping instruments in blue wrap might not be the best choice when your sterile processing department is responsible for turning around a high-volume of tools on a daily basis.

Richard Ortiz, CRCST, sterile processing manager at Stanford University Medical Center in Redwood City, Calif., is in charge of making sure more than 1,500 trays are reprocessed and returned to ORs quickly and safely. He relies on rigid sterilization containers to make sure instruments and flexible endoscopes are cared for properly and protected from inadvertent damage.

Rigid containers are made of stainless steel or anodized aluminum, which are sturdy materials that won’t easily bend or crack. They can also be stacked two at a time. “Ask any sterile processing director and they will tell you there never seems to be enough room to store instrument trays,” says Mr. Ortiz. “That’s why we need to be smart in order to maximize every inch of shelf space.”

Placing instruments in sterilization containers also avoids the cascade of complications caused when tools or devices puncture blue wrap. When this occurs, the instruments in the wrapped tray must be resterilized and rewrapped, time-consuming steps that slow down a busy day of surgery. “If used correctly, rigid containers protect instrument sets much more effectively and consistently than blue wrap and tape do,” says Mr. Ortiz.

Although industry experts differ on the expected lifespans of rigid containers, Mr. Ortiz says well-maintained containers can last for many years. “Every facility is different, and it all comes down to case volume, but we can use a single container six times in one day if necessary,” he says. “The containers require a significant upfront investment but are much more cost-effective than blue wrap in the long run. For me and my busy staff, the rigid container is always the best and safest option.”

A renewed focus on the six areas of endoscope reprocessing will get you through your busiest days.

There’s no secret to keeping patients safe while providing potentially lifesaving colonoscopies. The higher the volume a scope center has, the more it should double down on following the standard rules within the six commandments of endoscope reprocessing.

“Changing or modifying any of these essential steps to proper endoscope care will do more harm than good,” notes Casey Czarnowski, former clinical educator in sterile reprocessing practices at Stanford Health Care in San Francisco. “The six basic steps should apply no matter how busy your facility gets.”

Bedside care. Point-of-use precleaning consists of flushing a scope's channels and wiping off the exterior of the insertion tube immediately after exams are complete and before the scope is transported to the reprocessing area. Preassembled kits containing a syringe, basin, sponge and soap make this quick and easy.

Safe transport. Scopes are fragile and expensive. Rigid containers with high sidewalls safely hold them in place as they are brought to the reprocessing area. Federal regulations require containers to be labeled as carrying biohazardous material to alert staff that they contain soiled instruments. “Make sure the containers are made of a sturdy, puncture-resistant plastic, are large enough for the instruments to lie in without the tubes crimping, and high enough on the sides to keep coiled scopes fully contained,” says Mr. Czarnowski.

Leak testing. When scopes arrive at the reprocessing area, leak test the scopes with either a dry or wet leak tester, following the tester manufacturer's instructions for use.

Manual cleaning and flushing. Once the scopes have passed the leak tests, brush the narrow channels within the scope with the proper size brushes designed to accompany each scope and scrub the entire device, including valves and buttons set in all positions. After manual brushing is complete, connect scopes to an automated cleaner that flushes channels with enzymatic soap and/or a high-level disinfectant.

High-level disinfection. Place the scopes in an automatic endoscope reprocessor, which runs them though several cycles of cleaning, disinfecting, rinsing and alcohol flushes. This can take up to 45 minutes to complete. The alcohol flush is important, as it dries internal channels before scopes are moved to the storage area. Examining scopes with a small-diameter borescope after high-level disinfection is recommended to check the scopes’ lumens for residual bacteria.

Proper storage. To maximize drying and minimize the chance of recontamination, hang scopes vertically in storage cabinets that circulate air throughout the storage chamber to help keep scopes dry between uses. High-end cabinets provide a continuous flow of air around endoscopes and feature tubing connectors that blow a steady stream of filtered air through the channels.

Staff should be trained in how to clean all scopes, and one member should be assigned to keep abreast of any new reprocessing developments. “Rely on these sound practices to make sure your patients are treated effectively and safely,” says Mr. Czarnowski.

No-wrap containers are viable, cost-efficient alternatives for protecting instruments as they go through the sterilization process, transport and storage.

KARL STORZ

Today, healthcare facilities are confronted with escalating costs, unwanted waste and mounting compliance concerns in their Sterile Processing Departments (SPDs). Many hospitals and outpatient facilities that employ highly sophisticated KARL STORZ products, for example, are using sterilization trays that are outdated and costly. Furthermore, many are using trays in sterilization modalities that have not been cleared or validated for the products housed inside.

As part of the safe patient journey, surgical instruments go through decontamination and sterilization. Prior to sterilization, instruments are enclosed in a single-use, disposable polypropylene cloth, traditionally called blue wrap, which prevents entry of microbes and potential contamination. Disposable blue wrap presents a significant burden to hospitals and outpatient facilities in terms of cost, waste and operational efficiency.

KARL STORZ no-wrap containers are a superior alternative to sterilizing and protecting KARL STORZ products. The sterilization containers are a simple yet effective system for protection of endoscopic equipment and instrumentation during sterilization, transport and storage. Custom designed to accommodate KARL STORZ endoscopes, camera heads and instruments, KARL STORZ containers have been validated for a variety of sterilization modalities, including high-and low-temperature systems (e.g., autoclave, STERRAD, V-Pro maX).¹ Available in a multitude of sizes and configurations, KARL STORZ sterilization containers have applications for many surgical specialties, including but not limited to: Neurosurgery, ENT, Laparoscopy, Urology and Pediatric surgery.

Each KARL STORZ sterilization container includes a container base and lid with an integrated filtration system and silicone gasket to ensure a secure seal, as well as custom basket trays with silicone holders for instrumentation and accessories. Containers are available with single- or multi-layered basket trays, depending on the application. Basket trays for each container are pre-assembled with a combination of silicone brackets, holders and inserts that are securely fixed to the tray, with thoughtful consideration to the intended load of the container.

KARL STORZ sterilization containers are reusable systems that require the use of disposable accessories for each cycle, including filters, process indicator and tamper-evident seal. However, the disposable costs associated with KARL STORZ are minimal in comparison to the disposable costs associated with blue wrap sterilization. All containers feature an integrated filtration system where single-use filters are placed. Filter retention plates secure the filters in place, and vents are offset to reduce the risk of puncturing the filter and compromising sterility.

Prior to sterilization, a single-use bio indicator card is placed on the outside of the loaded container and a single-use tamper evident seal is placed onto the latch of the container. When the cycle is complete, markers on the bio indicators indicate whether the loaded container was exposed to sterilant or not.

Available in a variety of colors that correspond to methods of sterilization, seals are used to inform the next user whether the container had been opened at any point during storage. Additionally, disposable accessories are available after market, and differentiated by container type and sterilization modality.

KARL STORZ sterilization containers offer significant cost avoidance to healthcare facilities currently using traditional, blue wrap trays. Although blue wrap trays have a lower upfront cost, there are ongoing costs associated with use of blue wrap that are avoided by conversion to KARL STORZ sterilization containers, such as cost of re-wrap due to improper care and handling (e.g., tears).

According to a white paper study, a large health system conducted a study to evaluate the cost avoidance captured at their facility over a 3-year period by converting 25 traditional blue wrap trays to 25 KARL STORZ sterilization containers for use with their existing inventory of KARL STORZ camera heads. Comparing the total per-wrap costs of the blue wrap option vs. the total per-cycle costs of KARL STORZ sterilization, the study discovered a cost avoidance of $5.86 for each use of a KARL STORZ sterilization container. Based on early findings of the study, it is projected that the health system will realize a total cost avoidance of over $29,000 during the 3-year study period. Following their conversion to KARL STORZ sterilization containers, the organization expects to realize a return on its investment after just 14 months of use.

References:

1. STERRAD, NX, 100NX are registered trademarks of Advanced Sterilization Products. V-Pro is a registered trademark and V-Pro maX is a registered trademark of Steris Corp.

Note: For more information go to www.karlstorz.com.