How long can sterilized instruments be stored in peel pouches?

 Q

 Do you have any information that you can share with me concerning how long sterilized instruments in peel pouches can be stored, like in other departments? Also, are the terms ‘dust covers’ and ‘sterility maintenance covers’ the same term?

A

By the type of question, I must assume you are looking for support for writing a policy on storage of peel pouches in any location.

To my knowledge, there are no specific standards/guidelines stating sterile items have to be reprocessed (annually or any other interval) if not stored in a controlled environment.

What you need to understand:

1. Look to the instructions for use (IFU) of the peel pouches you are using for directions on storage.

2. Research the various standards and guidelines concerning storage conditions.

3. Explore various articles and technical manuals (training) on the subject.

You will combine all this information to write your policy, then have it reviewed by the proper team members within your facility.

However, AORN does speak to conducting a multidisciplinary risk assessment in such cases to determine what “events” should trigger the reprocessing of the stored items. For example, the multidisciplinary team could decide to reprocess any sterile item stored outside controlled storage areas each year, but they just need show they followed their own policy. They could also include the use of a dust cover or sterility maintenance cover as an extra layer of protection. This segues into the second part of your question.

As a side note, remember to keep the instruments in an open position while in the peel pouch to allow for sterilant penetration and contact of the sterilant on all parts of the instrument. There are many excellent products on the market to accomplish this task.

Dust Cover or Sterility Maintenance Cover? Same or different?

In my view, they are the same term. You must remember that, in general, they provide a barrier against moisture and dust (i.e., environmental contaminants) and are not to provide a microbial barrier. Again, follow the IFU of the product you are using. The majority of this class of products are made of plastic and have very specific instructions on when and how to apply after a sterilization cycle.

As a general reminder, no matter where peel pouches are stored (e.g., in a sterile supply area, emergency room cabinet, or a nursing unit storage room), always practice first-in, first-out (FIFO) inventory control.

As the department manager it is your role to ensure that any area having sterilized products from your department understand the correct way to store, handle, and open these items (in this discussion about peel pouches). Make it a point to provide in-service to all your users in every location. My other suggestion is do your own “milk run” of these various areas and audit their adherence to your facility policy. Use that information to provide feedback to your users. This can also help you develop your in-service program so that it is meaningful to the user.

For reference, here are some sections of standards and guidelines to investigate that will help you get started on forming a policy for use at your facility.

• AORN on sterile storage (section 4.3 - 4.3.8).
• ANSI/AAMI ST79 sections (9.7, 11.1 - 11.1.3).

In closing, when writing your policy, make sure to provide references for all your sources to back up the statements. This not only makes it easier to defend it to your staff but also to show support for the “why” of your policy if you were to be audited by an outside agency.