“Transport baskets and flexible sterilisation
packaging: the best of both worlds.”
Karina Engels
HALYARD HEALTH
BETTER CARE DESERVES A NEW NAME
Kimberly-Clark has been a leader in better care for nearly
100 years. Because we believe when you put care first,
healthier living is contagious. Now it’s time to move
forward. We’re bringing that belief with us and focusing on
preventing infection, eliminating pain and speeding
recovery
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EN ISO 11607 - Definitions
• Sterile Barrier System: minimum package that prevents ingress of
micro-organisms and allows aseptic presentation of the product at the
point of use demonstrated under test conditions which consider
sterilization process, handling, distribution, transport and storage
(amendment EN ISO 11607, 2014)
• Protective Packaging: configuration of materials designed to prevent
damage to the sterile barrier system and its contents from the time of
assembly until the point of use
• Packaging system: combination of the sterile barrier system and
protective packaging
Choice sterile barrier systems
Depending upon device, local habits, preference, logistics
Characteristics container
• Perceived as strong (secure feeling)
• Easy to store
• Quality bacterial barrier highly
dependent on maintenance
• Heavy
• High investment cost
• Noisy
Bacterial barrier containers
Measurement of the microbial barrier effectiveness of sterilization containers
in terms of the log reduction value for prevention of nosocomial infections
Sterile container:
CFU per 600 cm²
Paper filter: 2 out of 11
1000
900
800
700
600
500
400
300
200
100
0
Permanent filter: 14 out of 15
Paper filter
Permanent filter (teflon)
Textile filter: 9 out of 79
Textile filter
1 6 11 16 21 26 31 36 41 46 51 56 61 66 71 76
Num ber
Source: Dunkelberg et al; American Journal of Infection Control 2006; 34:285 - 9
Source: Dunkelberg et al; American Journal of Infection Control 2006; 34:285 - 9
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Recent publication AFNOR
FD S98 053 (2014)
National survey France
Characteristics flexible packaging material
Example: HALYARD ONE-STEP* or QUICK CHECK*
• Every sheet new bacterial barrier
• Light
• Easy to store
• No maintenance
• Possible pinholing or tearing
Pinholing sterilisation wrap
COMPARAISON DES CONTENEURS ET DES FEUILLES D’EMBALLAGE À USAGE UNIQUE POUR LE
CONDITIONNEMENT COMPOSITIONS D’INSTRUMENTS À STÉRILISER*
*Source: DIALLO S, BREBANT T, et al., Service Stérilisation Centrale, Bloc Opératoire Central,
Hôpital FOCH, presented CEFH Lyon 2012
The cause
“We have no space”
“We have no time”
“Our storage is poor”
“Changing shelves is too expensive”
“It is the OR who is stacking”
“It is the CSSD, they deliver us damaged
material”
“Transportation is the issue”
“The packaging material is not strong enough”
The frustration
“We had to cancel a patient”
“The surgeon was yelling”
“We are going to buy containers”
“We need to rent the loaner set again”
Typical approach
A sterilized tray is handled 4 to 5 times prior to opening
Step 1: Load sterilizer
Step 2: Unload sterilizer
on transport trolley
Step 3: Transportation
Step 4: Store sterilized
tray in OR
Step 5: Remove tray from
shelf
Step 6: Present
tray aseptically
in OR
4 to 5 times risk to damage
sterilized package!
Familiar?
The solution
Use of transportation baskets
Step 1: put the packaged
instrument tray in a
transport basket
Step 2: put transport baskets in the sterilizer loader: toploading and floor loading are possible
Use of transport baskets
The sterilized instrument basket is only handled at the point of aseptic
presentation
Step 3: put transport basket
in open or closed Stericart
Step 4: transfer the
transport basket to the
U-flex storage system
Transport baskets
Different types
Stakeable/nestable baskets
Grids
Grids with rim
Transport baskets
Different vendors
• Belintra
• Hüpfer
• Landanger
• .........
Characteristics transport baskets
• Initial investment cost
• Light
• Easy to handle
• Minimal maintenance
• Pinholing and tears reduced to......
• Increased patient safety
• Optimizes storage capacity
• Improved overview of inventory
Improved overview of inventory
Financial feasibility
?
?
?
?
£
?
?
?
?
Financial example
£
Hypothesis 1 Sterilized STU/day
200
£
Cost transportation
baskets
29.600 €
21.438£
22.785 €
16.502£
2.192 €
1.587£
54.577€
39.527£
(74€/basket 400 baskets)**
Annual amount
60.000
Cost Stericarts
(9 carts, different types)**
Sterilization cost/STU*
Total sterilization
cost/year
48.49 €
2.909.400 €
35.12 £ Cost U-Flex storage
system**
2.107.200 £
Hypothesis 2 Torn trays: 2% of case
Cost re-sterilization
58.188 €
*Source: BESCO study, presented Zeist, October 2014
**Prices are purely indicative
42.144 £ Total installation cost
Conclusion
• The use of flexible packaging e. g. Halyard One-Step* or Quick Check* provides an
excellent bacterial barrier
• Torn tray wrap can be prevented by using transport baskets, the so called basket-inbasket system
• The combination of both systems is userfriendly, provides optimal patient safety and
is financially feasible