Updated: Mar 10, 2022
Those who have worked in the sterile processing field for as long as I have ( almost 40 years) probably remember when disposable supplies were segregated. Supplies in boxes were stored in one area, and supplies removed from their shipping containers were stored in another, both in the Sterile Processing Department and the Storeroom. The reason for this was to reduce cross-contamination from outside contaminants that occur during transportation. The Sterile Processing department is designed with a break-bulk area to remove boxes before the supplies enter the department. In the mid-late 1980s, a cost reduction trend began when the Material Management/Storeroom staff began managing the supplies on the shelves, just about the same time that the staff in sterile processing began to manage the surgical sterile trays. The supply process change has created infection control risks. The Sterile Processing department has remained vigilant against microbe intrusion; however, the Storeroom has not.
It is not uncommon when entering the central storeroom in a hospital to find open boxes of sterile and unsterile supplies shelved in the same area as supplies in shipping containers. It is also common to find unrestricted access to the area and direct access to the outside environment (often with doors open). The ANSI/AAMI ST79:2017 11.1.1 states: "Sterile items should be stored under environmentally controlled conditions in a manner that reduces the potential for contamination. Sterile storage areas should be kept clean and dry." Most of the storerooms that I enter have debris, in many forms, on the floor. Routine cleaning rarely occurs. The shelves are dirty, and the temperature and humidity are rarely controlled. There are not any other areas in hospital units that allow for such storage conditions.
The handling of disposable supplies has also worsened since the transition. Sterile and unsterile supplies are often transported in open carts through unrestricted areas. Staff handing the supplies usually don't have adequate handwashing receptacles in their work areas, allowing for the cross-contamination of supplies from opening external boxes and handling clean and sterile supplies directly.
CMS, State inspectors, and infection control practitioners often failed to review central storerooms for infection control practices. Environment of Control (EOC) reviews are usually the only inspections and generally focus on fire safety and egress issues.
There is ample room for improvement with the management of supplies. The CDC reports an annual rate of 1.7 million HAIs and 99k associated deaths. Current practices in hospital storerooms could be a contributing factor. We need to get back to our roots and reduce the possibility of cross-contamination during storage.
At Evolved Sterile Processing, our consultants have a greater focus on sterile processing. With our decades of experience, we will help you develop better processes and educational resources for your staff.