Hand-rub agents; patient skin prep; smallpox vaccine; instrument tape; cardiac catheterization laboratory - Clinical Issues - question and answer

AORN Journal,  April, 2003  by Dorothy Fogg

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Question: In our facility, we use colored tape to mark instruments so that certain sets stay together and Instruments do not get moved from one set to another. According to the manufacturer and product literature, the tape is both gas and steam permeable. Occasionally it is necessary to flash sterilize one or more instruments from the set. When this happens, is It acceptable to flash sterilize the instruments for three minutes If there are no porous items in the tray?

Answer: Gas- or steam-permeable instrument tape is porous by definition. If the tape were not porous, the sterilant would be unable to permeate. Any time there is tape in the load, the load contains porous items and must be flash sterilized using the cycle recommended for porous items. If you are using a gravity displacement sterilizer, the correct cycle is 10 minutes at 270[degrees]F to 272[degrees]F (132[degrees]C to 133[degrees]C). If you are using a prevacuum sterilizer, the correct cycle is four minutes at 270[degrees]F to 272[degrees]F (132[degrees]C to 133[degrees]C) unless otherwise validated by both the sterilizer manufacturer and the tape manufacturer. In either situation, a drying cycle is not necessary unless you are using a single wrapper in a sterilizer specifically designed to flash sterilize that particular configuration. Manufacturers' recommendations should be followed carefully to determine the correct cycle, including drying time, for such a load.

Question: We are in the process of building a new area for our cardiac catheterization laboratory procedures and are having difficulty finding guidelines to assist us with the physical plant design. We have several questions. How many scrub sinks are required per procedure room? Do we need a separate locker room for catheterization laboratory personnel or can they use the OR locker rooms? Should the area have a holding room or can patients move from the intake area directly into the catheterization laboratory? What other requirements should we be aware of and where can we find supporting information?

Answer: The Facilities Guidelines Institute and The American Institute of Architects Academy of Architecture for Health, with assistance from the US Department of Health and Human Services, have published Guidelines for Design and Construction of Hospital and Health Care Facilities that will provide some direction for you. (10) The document does not specify the number of scrub sinks per procedure room, but it does indicate that hands-free scrub facilities should be provided adjacent to the entrance to procedure rooms. The document indicates that two scrub positions shall be provided near the entrance to each OR. The two scrub positions may serve two ORs if both are located adjacent to the entrance of each OR. If your catheterization laboratory is designed similarly, it would be reasonable to follow the same direction for the number of scrub positions, keeping in mind that a single scrub sink may contain several scrub positions.