By David Taylor III, MSN, RN, CNOR
Sterile processing (SP) is an essential aspect of patient care, ensuring that high-quality, clean, sterile and well-functioning devices are available when needed. Of all the critical processes SP professionals perform, the safe and appropriate transport of sterile items to the point of use is one that is frequently overlooked.
Transporting sterile or high–level-disinfected (HLD) items between various departments and floors and across buildings, campuses – and, in some cases, cities – has become more common. Because of scrutinized and shrinking budgets, health care organizations are seeking ways to get more return from their instrument and device investments. For some facilities, this translates to a push for the sterile processing department (SPD) to reprocess devices more frequently which, in turn, requires more transportation and delivery of those items to the user areas. The question that must be asked is how are those critical items being protected from contamination during transport, so they arrive in patient-ready condition?
Health care organizations have long struggled with the logistics of moving instrumentation and medical devices from one location to another, while maintaining integrity and the segregation of used (contaminated), sterile materials and clean items. Whether one works in a hospital, ambulatory facility, clinic or nursing unit – or for an organization with multiple campuses spread across a geographical area – it is vital that all involved in instrument transport are knowledgeable of the correct process. Also, regardless of whether devices must travel a short or long distance, it is imperative that transport practices comply with industry standards, regulatory guidelines as well as internal policies.
Let standards, best practices guide transport practices
Inappropriate device transport can lead to environmental contamination and instrument damage.
ANSI/AAMI ST79:2017(R)2020, for example, states that all personnel responsible for transport should avoid dragging, crushing, bending, compressing or puncturing the packaging.
All items should be inspected for integrity before being dispensed for or used in patient care. When transporting sterile and HLD devices, good body mechanics should be used, and the package should be kept parallel with the floor to avoid shifting during transit. ST79 recommends using a covered or enclosed cart with a solid bottom shelf to transport clean or sterile items. Further, it states that containers and packages should be placed securely and in a flat position and not extending past the edge of the cart shelf or table surface.
Sterile items should be protected from excess handling during movement and transport to minimize the potential for sterile package contamination or compromise. It is also important to transport processed items to the storage location as soon as possible. The end user should also carefully inspect the package visually for integrity and appropriate labeling immediately before opening and using a sterile item (the person who opens each package at the point of use typically assumes this responsibility).
Conclusion
As health care organizations consolidate their work processes and, in some cases, their SPDs, understanding how processed devices are transported from one location to another is vital.
Far too often, device transport is dangerously overlooked or undervalued; however, all safety- and quality-focused health care organizations must prioritize instrument transport and ensure that all individuals performing the essential function are knowledgeable about the standards, guidelines, regulations and policies and procedures – and committed to following them consistently. Doing so is critical for patient and employee safety and the protection of the devices being transported.
– David Taylor III, MSN, RN, CNOR, is an independent hospital and ambulatory surgery center consultant and the principal of Resolute Advisory Group LLC, in San Antonio, Texas. He has served as a contributing author for the Healthcare Sterile Processing Association (HSPA) since 2019.
