Dirty silicone mats & DIN trays

Q

 “We have silicone mats in my department. Some people leave them in trays with instruments when going through the medical automatic washer, and some people don’t. Also, some of our mats are very dirty. What advice do you have?”

A

 I have captured two pictures that will help highlight your concerns about the proper way to use silicone mats (right).

Your question indicates that dirty silicone mats are cleaned inconsistently and without a standardized practice at your facility.

Silicone mats are purchased with a purpose that they can add an extra level of protection (a “cushion”) to instruments in the tray or basket and are often used for delicate instruments.

Silicone mats (or pads) come in many sizes and shapes. Some are:

• On rolls or sheets that can be cut.
• Precut to the DIN tray size.
• In different colors.
• With specific trays designed to fit snugly in the tray.

In my view, all departments have silicone mats, and I have seen exactly what you are talking about—the inconsistency in cleaning silicone mats, which can cause them to look dirty. Thus, how can you reduce having dirty silicone mats in any department?

As in almost all my responses, you need critical thinking. This entails finding the instructions for use (IFU) for the silicone mats you are using. Dove tail that with research to put in a “Best Practice” in your Standard Operating Procedure (SOP). Ensure your SOP includes information on inspecting, cleaning, sterilizing, and any other relevant information.

As per your questions, it seems your department does not have any SOP.

Here is a very generic SOP you can use as a guideline and adjust based on the specific type of mat your department uses.

SAMPLE SOP FOR SILICONE FINGER MATS^1-3.

1. When received, the silicone finger mat should be cleaned prior to first use in accordance with the cleaning instructions found in the IFU.
2. Configure the mat properly to where the fingers point upward to accommodate the instruments that will be sterilized. The mat should be used to help hold, organize, and protect instruments.
3. Instruments should be arranged in a single-layer with adequate spacing to prevent them from contacting each other.
4. The silicone finger mat is reusable and should be cleaned and decontaminated prior to reuse according to the IFU for the mat.
1. Mats can be manually cleaned (preferred method) or can go through medical automatic washer.
2. Mats should not be washed (or placed inside) with the tray of instruments because they could prevent exposure of the cleaning solutions and rinsing of the instruments by blocking impingement.
5. Visually inspect the mat before placement in a tray or storage to ensure the complete removal of soil. Inspection should verify cleanliness, lack of damage (e.g., cracking in the mat, missing finger points), and proper function.
6. Mats should be dry before being placed in a tray with instruments.
7. Review the IFU for specific sterilization instructions (types/methods/cycles) for the silicone mat.
8. It is the processor’s responsibility to ensure processing using equipment, materials, and personnel in the processing facility to achieve the desired result. This could require routine verification monitoring of their process.
9. All staff will be trained in this policy by demonstrating how to properly use, clean, and inspect silicone mats.
10. The silicone finger mat has a life span and will require replacing if there are any signs of deterioration or loss of functionality. Dispose of product following the facility’s policy.

This should give you a start on resolving your concern and get cleaner silicone mats.

I used the term “DIN tray” in my response, and I am not sure everyone knows what this means; so, here is an explanation of the term DIN.

DIN stands for Deutsches Institut für Normung meaning German Institute for Standardization. The most common sizes of sterilization trays are DIN sizes. DIN sizing refers to a German Standard (DIN EN 285: 2016), which specifies requirements and the relevant tests for large steam sterilizers primarily used in health care for the sterilization of medical devices and their accessories.

References:
1. Chobin, Nancy (RN, AAS, ACSP, CSPM, CFER). (August 29, 2019). Surgical Instrument Decontamination: A Multistep Process. AORN Journal, September 2019, 110(3), 253-262. https://doi.org/10.1002/aorn.12784. (PDF on https://www.cbspd.net/wp-content/uploads/2019/10/Chobin-2019-AORN_Journal.pdf).
2. Griffin, Ava (BSN, RN, CNOR); Koncur, Patti (CRCST, CHMMC, ACE). (2015). CIS Self-Study Lesson Plan Lesson No. CIS 261 (Instrument Continuing Education - ICE): Human Factors That Impact Sterilization. Communiqué, May/June 2017, 34-38. MyHSPA (formally www.iahcsmm.org). Retrieved December 6, 2022, from https://myhspa.org/images/Lesson_Plans/CIS_Plans/CIS261.pdf.
3. Wood, John (BAAS, CIS, CRCST). (2015). CIS Self-Study Lesson Plan Lesson No. CIS 277 (Instrument Continuing Education - ICE): Instrumentation Assembly, Inspection & Protection. Process, January/February 2020, 48-52. MyHSPA (formally www.iahcsmm.org). Retrieved December 6, 2022, from https://myhspa.org/images/Lesson_Plans/CIS_Plans/CIS277.pdf. 
4. © National Surgical Corporation. (n.d.). Understanding sterilisation trays for CSSDs. Retrieved December 6, 2022, from https://nationalsurgical.com.au/understanding-sterilisation-trays-for-cssds/.