When a product enters a hospital, it becomes part of inventory. But, if it isn’t treated properly, it can become a liability rather than an asset.
Sterile products can be kept in their original packaging and issued as a whole quantity or they can be broken down and issued as individual packets.
Regardless, the environment in which these items are stored affects whether they are sterile when used. It is important to know the difference between sterile storage and a storeroom.
Most literature on storing sterile products is about the sterile storage environment. In this environment you need to store the items 8 to 10 inches above the floor, 18 inches below the ceiling or the sprinkler head and 2 inches from an outside wall. Products should not be crushed, bent, compressed or punctured.
They should not be stored under sinks, near exposed water or sewer pipes or in any location where they might get wet. Products should not be stored on floors or window sills.
Closed cabinets are preferred, but open shelving in a controlled environment is acceptable. The definition of a controlled environment is where outside access and traffic is limited.
Outside shipping containers and corrugated shipping cartons should not be used as storage units in the sterile storage areas. This regulation is per AAMI document ST 46 on steam sterilization and sterility assurance in health care facilities. (ANSI/AAMI ST 46:2002 5.9.3.2).
The document also states that the temperature in sterile storage may be as high as 75 degrees, but workers usually prefer lower temperatures in which to work.
The relative humidity should be between 30 percent and 60 percent, but never more than 70 percent because higher humidity levels can cause microbial growth.
The ventilation system should provide for four air changes per hour and the room should be under positive pressure (ANSI/AAMI ST 46:2002, page 12, Table 3). Walls, ceilings and floors should be able to withstand a wet cleaning process to prevent microorganisms from growing in the work space.
Once a product enters your facility, you are responsible for transporting it safely to the individuals who will use it.
I cannot begin to figure out the standards that different vendors use, but areas of the country that have seasons are the ones most affected by the differences in temperatures.
Usually a shipping carton is placed on a shelf, but an unopened shipping carton may come in contact with the floor until it is opened. If you have an open ceiling, clean products can be stored under the pipes, but sterile items should not.
If you only have closed shipping cartons in your storeroom, there’s probably no need to worry about these issues. But, if you open the products and issue items individually, you need to protect the sterile items in the same manner as in a sterile storage area.
Many sterile products have a tab on the end of the container that allows a product to be opened in a sterile manner by the nursing staff.
This is also a perfect location for dust and dirt to accumulate. Dust and dirt may harbor fungi, bacteria and molds. A sterile item should not be exposed to any adverse conditions if possible.
The ceiling should be solid and the floor sealed so they can be cleaned as often as necessary. It is critical that no dust, dirt or dust bunnies exist in the storage area.
Shelves should be cleaned weekly. While cardboard boxes may be used to store products, cardboard should not be used to line shelves because cardboard harbors bacteria and vermin that can spread disease.
Open items should be protected from the environment in some manner. Storage conditions may vary somewhat, but the room should be treated as a clean area.
Our goal as health care professionals is to provide patients with the best outcome possible.
Ask an infection control nurse about the storage of sterile items that are issued individually out of your storeroom. It is possible to have two different standards of sterile for the same product. It’s like asking Mom if the bathroom is clean after you cleaned it—your idea of clean and hers may be different.
Michael Murphy is the manager of central sterilizing at the University of Iowa hospitals and clinics, Iowa City.
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