OR Manager August 2023 - 26

Keeping it sterile: Fundamentals of sterile storage
STERILIZATION & INFECTION PREVENTION
sing sterile items in surgery is a
fundamental practice, not a rudimentary
one that can or should
be taken for granted. Put simply, using
unsterile items can result in a patient
infection. If sterile storage conditions
are not appropriate, the items can become
contaminated. Such contamination
may go undetected, rendering
items unsafe and unusable. Therefore,
healthcare facilities must take action
to create an environment that properly
protects sterile packages. This includes
securing a proper sterile storage environment
and developing policies and
procedures to help ensure sterile packages
are safely stored and handled.
U
Sterile storage requirements
Sterilized items should be stored in a
room that is environmentally controlled
to maintain optimal conditions for sterile
integrity of the packages and reduce
the potential for contamination.
The sterile storage area, preferably an
enclosed room, should be easily accessible
from the sterilization cooling,
breakout, and case cart staging areas.
It should be designated as a semi-restricted
area, requiring those who enter
to wear clean scrub attire. It should
also be inaccessible to general traffic
flow patterns or to untrained or unauthorized
personnel.
All surfaces should be cleanable,
durable, smooth, and seamless. Floors
should have a cove base (ie, trim installed
to transition from the floor to the
wall). This provides a surface that allows
for ease of cleaning and assists in
preventing buildup of dirt and debris in
crevices. The area should include hand
hygiene stations and feature adequate
lighting, both for personnel safety and
so that package labels can be read
easily.
The air supply should be as clean
and dust-free as possible. Doors and
internal windows should remain closed
when not in use-and any windows to
the external environment should remain
closed at all times. Air pressure should
26
OR Manager | August 2023
be positive in relation to surrounding
areas so air flows out of sterile storage
when a door or window is opened,
reducing the chance of airborne contamination.
There should be no freestanding
fans to agitate dust or debris.
Temperature, humidity, and air pressure
should be monitored and recorded at
least daily.
Items arriving from vendors should
be received in a breakout room. Ideally
this room should be located adjacent
to sterile storage so the packages can
be safely removed from their shipping
containers. External shipping containers
and corrugated boxes can collect dust,
debris, and insects during shipment
and carry contaminants into the area.
These cartons should not be allowed in
clean/sterile storage areas.
Sterile items should be stored to
protect against contamination and allow
for adequate air circulation. The shelving
must be at least eight inches above
the floor, and the bottom shelf must be
solid to protect items from environmental
cleaning. Supplies on the top shelf
must be 18 inches below the ceiling
or sprinkler heads to ensure sprinkler
system effectiveness. Although not required,
a solid top shelf helps protect
sterile items from dust. Shelving units
should be at least two inches from outside
walls to prevent contact between
sterile items and condensation that
could form on the interior surfaces of
outside walls.
The design of the sterile storage
area should be spacious enough to
allow easy access to all shelves and for
cart movement up and down the aisles.
BY SUSAN KLACIK
The shelves should be sized appropriately
to fit the stored items. Trays that
overhang shelving pose a safety hazard
to all who work in the area and may become
contaminated by people walking
by and brushing against them. Sterile
packages should be handled with care
and positioned so they are not crushed,
bent, compressed, or punctured. Sterile
items should never be stored on floors
or windowsills or near or under sinks,
exposed water pipes, sewage lines, or
air conditioning drains.
For safety and ease of handling,
heavy instrument trays should be
stored on middle shelves. Lightweight
packages should be placed on higher
shelves. Sterile packages should be
carefully lifted and never dragged
across shelving. Transport trays are
available with solid or perforated bottoms
to prevent tears in wrappers during
handling. All equipment used to
transport and store sterile packages
should be maintained, organized, clean,
and dry.
All personnel play role in sterility
maintenance
Having a storage area designed to meet
sterile storage requirements does not
prevent all types of package contamination.
Staff members can protect the
integrity of the packages in the sterile
storage area by following the handling
protocols established by the healthcare
facility. Soiled items should not be
brought into the area.
Staff should maintain a high level
of personal hygiene. This includes having
clean hair and body; having short,
natural nails (ie, no polished, lacquered,
or artificial nails, or natural nails extending
beyond the fingertips); and wearing
clean, healthcare-issued scrub attire.
Hand hygiene should be performed frequently
by traditional soap-and-water
handwashing or using waterless hand
sanitizers according to facility policy.
When handling packages, hands must
be dry to prevent contaminating the contents.
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OR Manager August 2023

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