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A panel of veteran operating room nurses shared their experiences in using packaging designed for aseptic presentation at this year\u2019s <\/span>thePACKout<\/a><\/span> conference in Coronado, California.<\/span><\/p>\n Aseptic presentation is the process of transferring sterile products from sterile barrier packaging systems to a sterile field. The process uses procedures that minimize the risk of microbial contamination, with the aim of reducing surgical site infections (SSIs).<\/span><\/p>\n SSIs are a big deal for not only patients but also hospitals\u2019 bottom lines. SSI\u2019s make up about 20% of health care associated infections and 5% or more of surgical patients develop an SSI, according to a published <\/span>review<\/a><\/span>.<\/span><\/p>\n Contamination of an incision with microorganisms from the patient\u2019s microbial flora during surgery is the most common cause of SSIs, which are associated with significant morbidity and extended hospital stays. In fact, the authors report that SSIs extend a hospital length of stay an average 9.7 days and increase the cost of hospitalization by more than $20,000 for each admission.<\/span><\/p>\n Since up to 60% of SSIs are thought to be preventable with the use of evidence-based measures, SSIs have become a pay-for-performance metric and a target of quality improvement efforts, according to review authors.<\/span><\/p>\n \u201cThe Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals if they can pinpoint the surgical site infection back to the hospital\u2019s [practices],\u201d says Malinda Elammari, a clinical education specialist for <\/span>Healthmark Industries<\/a><\/span> and co-moderator of thePACKout session \u201cHow Aseptic Presentation Impacts Healthcare Workers and How to Incorporate Usability Lessons into Your Packaging Designs.\u201d\u00a0<\/span><\/p>\n A growing body of evidence suggests packaging could be a route of contamination for sterile devices during aseptic presentation, according to a paper published in <\/span>PLOS ONE<\/a><\/span>. And packaging design and opening technique play roles in the success of the process, the authors write.<\/span><\/p>\n In 2019 a major revision of International Organization for Standardization (ISO) 11607-1 was released for industry use, with the addition of section 7 addressing Usability Evaluation for Aseptic Presentation, according to session co-moderator Matthew TerBush, director of packaging innovations at <\/span>Packaging Compliance Labs<\/a><\/span>, which provides medical device packaging testing and design.<\/span><\/p>\n Section 7.2 of the standard requires that manufacturers assess the ability to do the following through a usability evaluation for aseptic presentation, according to Packaging Compliance Labs:<\/span><\/p>\n \u2022 Identify where to begin opening a sterile barrier system.<\/span><\/p>\n \u2022 Recognize and perform the technique required to open the sterile barrier systems without contaminating or damaging the contents.<\/span><\/p>\n \u2022 Subsequently present the contents aseptically.<\/span><\/p>\n Circulating nurses and scrub technicians typically interact with the packaging during aseptic presentation, according TerBush.<\/span><\/p>\n \u201cNobody thinks about packaging until we have a problem with it,\u201d says Elammari, who began her medical career as a surgical technologist.<\/span><\/p>\n What could go wrong was on display during the session, when an audience member participated in an aseptic presentation on stage, in a mock OR, using mock packaging. She opened the packaging only to have its contents fly out and hit the floor. And one could argue that she wasn\u2019t as stressed as a nurse or tech would be in a real-world operating room (OR).<\/span><\/p>\nPackaging matters.<\/h2>\n
Panelists weigh in.<\/h2>\n