Checking wrapped trays and instruments

[WarmBlanket]

Hello all ! At my hospital most of the instrument trays come from sterile processing wrapped in two layers of heavy blue paper . (I hope most of you are familiar with this method). Even if your facility uses metal trays for full instrument sets, every hospital I have worked at uses this blue paper to wrap individual items that do not go into peel packs such as mallets and large retractors . My question is this : after you remove the wrapper do you examine it for holes? Do you hold it up and look for light coming through that would indicate a cut or hole? Our new policy is that nothing can be put on the backtable until the covering is checked. I have always examined all packs to ensure they are intact before opening and would like to know how it is done at your hospital. Thanks : )

[MamaCheese]

Absolutely!! We hold all blue wraps up to the lights to inspect them for holes. We used to contantly have holes. Not so much anymore now that they've lined all our shelves. They also place heavy blue wrapped items in a plastic tray (like a lunch tray) so they won't be dragged across surfaces when the cases are being pulled.

[staceyp413]

Old employer never

Current employer always

**Looking to convert to metal trays/sets/etc as much as possible. Also, looking at the weight of those type of instrument trays.

[MereSanity]

I believe our weight limit is 25 lbs. We also look at the blue wrapper before sets go on the back table...of course the peel packs we examine before we open. We got away from the metal trays (or maybe it just seems that way). Just be sure to check for filters before they go on the back table (never seems to fail once you put one on the back table you notice no filter and then the whole table gets ruined). Always nice when a patient is rolling in the room

[Scrubby]

Our instrument trays usually come in gensis tins:

http://swmedical.com/view_category.php?category=851

But sometimes we have trays and other single instruments wrapped in the blue kymguard. I always check for holes but it's amazing how many senior nurses will just take the instrument and plonk it down on their sterile field. I worked with a nurse the other day who just took the instrument without waiting for me to check, there was actually a hole in the wrapping so they had to wait for me to get them a brand new set up. They gave me a bit of a hard time saying to hurry up. I told her that checking for perforations is a basic OR skill and she had nobody to blame but herself.

[GadgetRN71, ASN, RN]

Hello all ! At my hospital most of the instrument trays come from sterile processing wrapped in two layers of heavy blue paper . (I hope most of you are familiar with this method). Even if your facility uses metal trays for full instrument sets, every hospital I have worked at uses this blue paper to wrap individual items that do not go into peel packs such as mallets and large retractors . My question is this : after you remove the wrapper do you examine it for holes? Do you hold it up and look for light coming through that would indicate a cut or hole? Our new policy is that nothing can be put on the backtable until the covering is checked. I have always examined all packs to ensure they are intact before opening and would like to know how it is done at your hospital. Thanks : )

Yes, this is what I was trained to do when I rotated through Ortho...it's become habit now. I also check peel packs all the time and good thing, because I've caught a few compromised packages that way.

[midlife_nurse]

Yes, we always check. Most of our instruments are in pans, and a lot of vendors use their own proprietary pans that get wrapped. The ones with rounded edges almost never get holes (example Synthes and Medtronic spine), and the ones with square corners get holes OFTEN (example Synthes Ortho). The vendor reps are good about having spares for pans that puncture easily. One day I had to open THREE Synthes Small Fragment pans for one case because of punctured corners, and those are SOOO heavy. It's hard for the scrub to hold the pan above waist-level while you check. I don't believe they're only 25 lbs!

I wish we had more of the smooth blue plastic trays to rest the pans on and avoid punctures... would be nice.

[MERRYWIDOW46]

Nothing wrapped in blue paper or peel packaged goes on table until it is verified NO HOLES. Basic standard of OR practice.

[scrubcircrn]

If youve ever worked much ortho its a constant habit to check for holes. Its not that unusual for Rep trays to get worn out and have sharp corners that puncture blue wrap. One total set I unwrapped had 4 out of 7 trays contaminated by holes. At our facility we check all wrapped packages.