OSE_1301_part2_Layout 1 1/11/13 10:58 AM Page 127
S T E R I L I Z A T I O N
A S S U R A N C E
1. Indicator placement
The proper placement of chemical indicators inside wrapped instrument trays or containers continues to be an issue at the front line. Be
sure to place chemical indicators in the geometric center of a
wrapped tray — the spot most difficult for steam to reach — to verify
that the sterilant has reached the center of the tray as recommended
by the Association for the Advancement of Medical Instrumentation.
For rigid containers, check with the containers' manufacturers for the
most challenging locations for chemicals indicator placement (usually
at 2 opposite corners of the inside basket). For multi-level instrument
sets, place chemical indicators on each level.
In far too many instances, however, operating room staffs want indicators placed on top of reprocessed instrument sets so they can
immediately see that steam got to the instruments before touching the
contents. (If a nurse takes apart the instrument set and discovers the
indicator placed properly in the center of the tray didn't turn, her
gloves might be contaminated and she'd have to break down the
entire sterile field and start setting up the case again.)
But just because steam reached the top of a wrapped tray doesn't
mean it reached the middle. Isn't it better to know the instruments
you're about to use are safe instead of moving forward based on a
chemical indicator that may or may not give you an accurate reading?
Worries about case efficiency should never trump ensuring instrument
sterility.
J A N U A R Y 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
1 2 7
