instrument count sheets

[bjsmsn]

An OR standard is for instrument counts to begin in the sterile processing department. we have templates on which the instruments are listed for each set. They serve both as our graphics and as the instrument count sheet in the OR. we were then putting the sheets in the tray, processing the set and sending it to the OR. But now I find it is not recommended to put printed material in the instrument trays prior to processing. I would like to hear from members about how they handle the instrument count sheet from in CSP.

[jrc]

I fold the count sheet in half so the ink is on the inside and put it in the set.

[Francisco]

At my hospital, we also fold the count sheet in half and then place the count sheet in the set. We have yet to have an issue.

[sonny1388]

There is a double issue with using count sheets inside sets. The first deals with either the paper or the ink being stuck to the instruments during sterilization. The second is due to the ink used in printing the count sheets, which is not declared by the manufacturer as "non-toxic". The first issue can be dealt with by, as stated above, folding the count sheets in half with the ink to the inside. Another precaution we take is to cover the set with a towel and put the count sheet on top of the towel. The second issue is a bit tougher. I have an e-mail in to various manufacturers of ink to see if they can get me some info on the toxicity of the ink. However, as we have not had any effect on patient safety or outcomes that we know of, we continue to use count sheets in our sets. It seems more of a risk to not have the count sheets than any effects the ink might have.

[Scarlette Sloan]

In our department we fold the count sheet and place it into a Propper sterilization bag size 2"X10".

[sonny1388]

scarlette: Are you then putting the bag inside the wrap/box of the set? If so, you may want to make sure that the staff knows that the paper is still not considered sterile.

[Scarlette Sloan]

scarlette: Are you then putting the bag inside the wrap/box of the set? If so, you may want to make sure that the staff knows that the paper is still not considered sterile.
Sonny,
Yes, we do put them in or instrument sets. In fact they use a lot of bags in sets with small peices.
Why is their an indicator on the bag???? It clearly states "sterile when turned to black" ???? I would love to get rid of the bags, but with that printed on the bag I don't have a leg to stand on. Any advice would be appreciated.

[sonny1388]

The issue is not necessarily with the bags (although AAMI recommends NOT using them inside wrapped or boxed trays) so much as it is with there has been no validation or instructions on how to sterilize paper. Here is a quote from the online communique on the main website that might help (hope they don't mind!).

Q: We use peel pouches to hold small items inside of our instrument sets. We have been told that we can no longer use them. Why?
A: The use of paper/plastic laminate packages inside of instrument sets is not recommended because the pouches may interfere with air removal, steam contact and drying. (ANSI/AAMI ST46.5.6.2.4) There are several other options for holding small items within sets such as small mesh trays and baskets, silicone mats, and more.

http://www.iahcsmm.org/q_and_a.htm

[Harvey Johnson]

We place the count sheet inside the tray in a letter size glassine instrument envelope, sealing the flap with an integrator and indicator tape. Other style pouches are not allowed in the tray.

[sonny1388]

I have not heard of this type of instrument holder, do you have any ordering info on it? I would be interested in checking them out. I would still question the sterility of the paper, but it sounds like it would be a great alternative for small pieces or instruments in a set.

[Harvey Johnson]

The envelopes are made by Westvaco, they have a web site, www.meadwestvaco.com you might be able to locate a distributor in your area from there.
We use six different sizes, number 11 size, item number 5SKT53 for the count sheets.
Let me know if you have a problem getting samples, I will mail you a few to check out....

[Scarlette Sloan]

Sonny I believe what you are quoting is the same bag that we are talking about. the quote is a plastic/paper pouch. Thouse are not to go in to the trays. We use Propper Sterilization Bags, they are made to go in the trays only.
I have these is in stock now.

Here is the info I have. Propper is the brand name, Sterilization bag
# 021003 and # 021003 .....Propper Mfg. Co. Long Island City NJ 11101 (800) 832-4300 http://www.proppermfg.com/

Let me know what you think Sonny :)

Thanks,

Scarlette

[sonny1388]

spd soup and Scarlette:
I have contacted both of these companies to get more info on their products. Props to both of you for finding what seems to be a very suitable solution to not being able to use standard peel pouches inside sets! Of course we are still looking at paper not being sterile because, well, it's paper, but this may work out well for keeping it off of the instruments!

[Scarlette Sloan]

Sonny,
Did you ever get samples of the paper bags? what did you think of them????
Scarlette

[sonny1388]

Scarlette,
I did hear back from WestVaco, who didn't seem to know anything about the ability for their bags to be autoclaved. Not sure if I was talking to a new person, but he claimed to have talked to several other people who didn't know any more than he did. He asked me to send him a sample so he could try to get more information...lol. I never did hear back from the rep from Propper, but I will try again. I was also reading a mag in the directors office the other day and found one from HealthMark with paperwork stating that it can be used inside a wrapped set and also has parameters for which cycles it can be used on. Let me know if you want some info on these bags as well. I will let you know as soon as I hear back from Propper.

[Harvey Johnson]

Sonny,
You are right, the enveloopes have been used here for at least 15 years to wrap small items as well as content sheets. No one ever questioned if they were validated!
I am checking, thanks to your note, we may be shopping also!
Thanks again,
Harvey Johnson
Tuality Healthcare