[Louise Christine Grant]

Dear Liz,
We use Compactus shelving in 2 of our Operating Theatre Suites up here and yes they are wire shelving.
The standard compactus usually comes with only 5 or 6 shelves which then enables the trays to be stacked. Stacking of the trays is not best practice with AS4187:2014, so we are going to add extra shelves onto each shelf unit so the shelves are closer together and the trays cant be stacked.
We are very pleased with the efficient use of floor space this enables. Although you need to be careful of the weight limit of your floor if you are putting them into a pre-existing Operating Suite, especially with the Orthopaedic shelf units.

Regards

Louise Grant PhD Cand, MCl Sc(Periop)
Project Consultant Reprocessing Compliance
Top End Health Service | Northern Territory Government
Room 221, Building 4, Royal Darwin Hospital,
Rocklands Drive, Tiwi NT 0810 | PO Box 41326 Casuarina NT 0811
t 08 8944 8005 | m 0404 491 183 | e Louise.Grant@nt.gov.au | http://www.health.nt.gov.au

TEHS Vision: Building Better Care | Better Health | Better Communities Together
TEHS Values: Trust and Teamwork | Excellence and Equity | Honesty and Accountability | Service and Innovation

Dear Brains Trust

For those of you who utilise compactus storage systems in your Theatre Suites for housing procedure trays etc. Does your compactus system comprise solid shelving or wire shelving to allow potential dust to fall to floor?

With Thanks in advance

Liz Vanderlinde
Infection Prevention Control Co-ordinator
North West Private Hospital
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Brickport Road, Burnie TAS 7320, Australia
T +61 3 6432 6005 F +61 3 6431 5766
E liz.vanderlinde@healthecare.com.au W
Healthe Care Hospitals are accredited by ACHS NSQHS Standards or ACHS EQuIP National
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QIC Standards
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[Louise Christine Grant]

Dear John,
I would also be interested to hear what other hospitals are doing with their screw banks.
I have similar concerns about what damage continual resterilisations does to the screws and plates and the lack of traceability that results.
Another concern of mine is how clean are these screw containers? They are usually not unassembled when they are put through the washer disinfectors.

With screw breakages, there is also the skill of the person driving the screw.

From my many years of experience as a perioperative nurse, on most occasions the surgeon and or trainee know what size screw they want with sufficient timing for the circulating nurse to open a sterile screw and not delay the surgical procedure at all.

Regards

Louise Grant PhD Cand, MCl Sc(Periop)
Project Consultant Reprocessing Compliance
Top End Health Service | Northern Territory Government
Room 221, Building 4, Royal Darwin Hospital,
Rocklands Drive, Tiwi NT 0810 | PO Box 41326 Casuarina NT 0811
t 08 8944 8005 | m 0404 491 183 | e Louise.Grant@nt.gov.au | http://www.health.nt.gov.au

TEHS Vision: Building Better Care | Better Health | Better Communities Together
TEHS Values: Trust and Teamwork | Excellence and Equity | Honesty and Accountability | Service and Innovation

Can I learn from others about how you have managed these please? Has anyone got data on screw breakages?

[ We have a large number of screw banks in use. These get replenished with new screws to replace those used. And so most of these screws go through an undocumented series of sterilisation cycles.

Clear concerns include:

a) The new screws have instructions for use that preclude resterilisation

b) The AS4187 says we should track all reprocessed material like this and not reprocess ad infinitum

c) That structural integrity of the screw is compromised (might be associated with breakages in patient ) There may be other deleterious changes to the material as well.

The alternative to banks is dispensing individual screws as required by each case. Other countries have mandated such. More expensive – we are getting resistance to change!

Thanks
John
Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49214444 | F: 61 2 49214440 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
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[Louise Christine Grant]

Dear Kirsten,
AS4187:2014 says somewhere (sorry cant find specific section a the moment) that the acceptable range for relative humidity for a sterile store room is 35 to 70%, with an acceptable temperature range of 18 to 250C. There does not have to be condensation on the items for them to be affected by an increase in humidity. If the packaging gets damp then the bugs on the outside can “wick” through and contaminate the contents. So Id say with the humidity going that high the sterility has been compromised.
It has recently happened in our sterile storeroom when the air conditioning stopped working in the specific room where the orthopaedic trays are stored. The humidity in the room was elevated and the filter papers on the orthopaedic trays had dampened despite the outer metal containers not having condensation on them. So all the orthopaedic trays had to be resterilised.

Regards

Louise Grant PhD Cand, MCl Sc(Periop)
Project Consultant Reprocessing Compliance
Top End Health Service | Northern Territory Government
Room 221, Building 4, Royal Darwin Hospital,
Rocklands Drive, Tiwi NT 0810 | PO Box 41326 Casuarina NT 0811
t 08 8944 8005 | m 0404 491 183 | e Louise.Grant@nt.gov.au | http://www.health.nt.gov.au

TEHS Vision: Building Better Care | Better Health | Better Communities Together
TEHS Values: Trust and Teamwork | Excellence and Equity | Honesty and Accountability | Service and Innovation

Dear colleagues,
At what level of humidity and over what time frame would it take for condensation to form in a sterile storeroom where temperatures have fluctuated between 19 and 26 degrees over a 24 hour period and humidity has peaked at 90%?
Reason being, we have been advised that sterile stock is uncompromised at 26 degrees unless condensation has formed causing the trays to become damp.
Thanks for your assistance.
Kind regards
Kristin
Kristin Ryan-Agnew
Kristin Ryan-Agnew (MPH/Grad Cert IP&C)
Infection Prevention & Control Clinical Nurse Consultant
The Tweed Hospital

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