Making the Case for Rigid Containers

Why continue to carefully cover instrument trays with blue wrap — making even folds, straightening the edges and neatly taping the package shut — when you can place tools in the customized inlays of rigid sterilization containers, snap on a lid and send them through the autoclave? The choice seems obvious when you consider the benefits rigid containers offer to time-strapped sterile processing professionals.

You can make a compelling case for investing in rigid containers by focusing on greater instrument longevity. "Rigid containers simply protect instruments better than blue wrap does," says Nancy Chobin, RN, AAS, ACSP, CSPM, CFER, president of Sterile Processing University, a New Jersey-based organization that provides online continuing education for sterile processing professionals. "That's especially important when you consider the amount of money facilities invest in surgical instruments. An average hospital easily spends more than $1 million in basic instrumentation."

Rigid containers are designed to keep even your most delicate instruments safe and secure with customizable posts, dividers, brackets and sprockets. This is especially important for particularly vulnerable tools. "Microsurgical instruments are so delicate, you have to do everything you can to protect them from damage," says Ms. Chobin. She points out that a customizable rigid sterilization container tray for eye instruments can include a small tray where each instrument can be secured in its own sprocket. "Because of the design of the inside of the basket, you're able to put these microsurgical instruments through the washer in a way that you never have to touch them by hand," says Ms. Chobin. "The instruments are no longer damaged."

While rigid containers do provide greater instrument protection, it's up to you to make sure you purchase models that are right for your facility (see "Get the Most From Your Vendor" below ).

Some reprocessing professionals swear wrapping and taping instruments in blue wrap is a more time-consuming process, while others feel it takes virtually the same amount of time to load instruments into a rigid container.

Assembly time aside, most sterile processing department leaders say rigid containers offer a level of consistency with respect to instrument care you can't get when staff wrap instruments in blue wrap. You can standardize the way they're supposed to apply wrap, but individuals will always create their own slightly different way of doing it, which could impact the integrity of the wrap, says Ms. Klacik.

Some SPD workers still stack instruments wrapped in blue wrap, even though the weight of those stacks can create air pockets and cause the wrap to tear. Ultimately, stacking wrapped instruments can compromise the instruments' sterility. Rigid containers, however, are designed to be stacked. "Containers can help free up space because you can stack them in storage," says Ms. Chobin.

While blue wrap can be recycled or upcycled (see "Going Green for the Greater Good" here) there are plenty of facilities that toss blue wrap in the trash, adding to the staggering amount of OR waste that's sent to landfills each year. Rigid containers, on the other hand, are an environmentally superior option. That's something that facilities should keep in mind when deciding between wrap and containers. "Under AORN's packaging guidelines, if all else is equal among the options you have at your disposal, you should consider the environmental impact," says Ms. Klacik.

Rigid containers require a significant initial investment, with a single container costing $300 to $500. You have to consider the long game, however. "The lifespan of these containers can be 15 years or more," says Ms. Chobin. If it costs $4 every time you wrap an instrument tray and that tray is wrapped daily, you'll spend $20 per week on wrap, and $15,600 over a 15-year period.

That expense doesn't account for the disposal costs associated with blue wrap, which can add up. "It's not just the cost of the container versus the cost of the wrap," says Ms. Chobin. "You must also consider the expense of disposing or recycling of blue wrap and the staffing hours of the workers who collect it and send it out. That time is money."

Based on the clear benefits associated with rigid containers, you have to wonder why more facilities don't do away with blue wrap for good. Cleaning concerns can be an issue. Rigid sterilization containers must be cleaned between each use, but this is a corner that gets cut more often than it should.

"Containers aren't being regularly cleaned in about 20% of facilities I visit," says Ms. Chobin. She believes there's a common misconception about the clean-between-each-use mandate: Some staff members believe containers that aren't brought into the OR don't have to wiped down. "I don't know where that assumption started," says Ms. Chobin. "But the instructions for use from every container's manufacturer state their containers must be cleaned after each use.

"Rigid containers are cost-effective, they've been proven to prevent instrument damage and they're an effective barrier against contamination," she adds. "I think rigid containers are one of the best things that's ever happened to sterile processing." OSM