Did you ever think about what needs to be done if you are transporting contaminated or sterile instrumentation from your organization to another location? It’s not simply putting them in a box, putting them in the car, and sending them to another location. Transporting contaminated or sterile instruments outside of an organization requires careful attention to prevent damage, contamination and ensure safety.
Use Appropriate Containers: Dirty instruments should be cleaned, and blood and bioburden should be removed at the point of use. Then, the instruments should be sprayed with an enzymatic solution or foam prior to transport. Finally, place dirty instruments in an impervious container that is leak-proof and puncture resistant. The container should be labeled with a biohazard symbol.
Sterile instruments being returned to the organization should be placed in a clean impervious container that is leak-proof and puncture resistant.
- Immediate transport: Minimize the time between point of use and decontamination by transporting contaminated instruments as soon as possible. This reduces the time that allows for the formation of bioburden on contaminated instruments. Additionally, expeditious processing returns sterile instruments to inventory, reducing possible delays in surgical cases.
- Seal and Secure: Seal the container securely and consider using tamper-evident seals to ensure the packaging hasn't been tampered with during transport. If direct site to site transport is not possible, ensure that the vehicle is locked during stops.
- Separate from Contaminated Items: Ensure that sterile instruments are transported separately from contaminated items. Use different vehicles or compartments if necessary. AAMI ST-79 states that, “Vehicles used for transporting contaminated items between healthcare facilities should provide for the complete separation of contaminated items from clean and sterile items. Transport vehicles and handling practices should allow for ease of loading and unloading.” The vehicle should not be left unattended and should be completely enclosed.
- Temperature and Humidity Control: Maintain appropriate temperature and humidity levels during transport to prevent damage to the instruments and contamination. Per AAMI ST-79, “In geographical areas where high humidity is the norm, testing should be performed to determine the potential for absorbent items to become contaminated and for the contents of sterile packages to become wet from the condensate that can occur on metal or plastic surfaces.” Short transit times may not present a risk but considerations for longer transit times may require a more controlled environment. Staff should inspect packaging for compromise as a result of temperature and humidity and reprocess instruments as needed to ensure sterility.
- Documentation: A list of items and their quantities being sent to the facility must accompany the items. A three-part form is recommended; the original copy is retained in the sending facility, and the other two copies travel with the items to the receiving facility. Manufacturers’ instructions for processing all devices sent must accompany the devices, or they will not be processed. At the receiving facility, the forms are presented to the supervisor/manager who should verify that all manufacturers’ instructions have been received. Return one copy of the inventory sheet confirming all items sent are being returned.
- Agreements: Develop a written processing agreement between the facilities involved, outlining the responsibilities and procedures for transporting sterile instruments. This agreement should be approved, reviewed and signed by the respective sterile processing department managers. Each manager should retain a copy of the signed form and maintain it with department records. Each facility’s legal counsel should review the “contract” to ensure both facilities are legally covered.
NOTE:
- Specify that the facility must report any positive BI test results immediately and send a copy of the sterilization log form showing the information on how the device was sterilized.
- It is important that the sterilizing organization understand that they will be required to have available all disinfection/sterilization documentation in the event that the sending organization is undergoing a regulatory survey.
- Training and Compliance: Ensure that all personnel involved in the transport process are trained in handling contaminated and sterile instruments and comply with relevant guidelines and regulations. Check with your local and state requirements regarding transport of contaminated surgical instruments. There may be more requirements such as special handling and training.
In summary, while this seems like a lot of work, it is equally important to remember you are assuming responsibility for sterilizing these instruments/devices; therefore, you need specific documentation to protect yourself, your facility, and most importantly, the patient.
References
- Best Practices for Transporting Soiled Items, Nancy Chobin, RN, CSPM, CFER, Infection Control Today, November 21, 2016.
- www.OSHA.gov - 1910.1030(d)(2)(viii) and 1910.1030(d)(4)(ii)
- AAMI ST79 Manual
For questions or to learn more contact the C&A team at 704-573-4535 or email us at info@courtemanche-assocs.com.
