Do you check for holes after you open a tray?

TakeTwoAspirin, MSN, RN, APRN · Mar 1, 2009

Every time! It is amazing how many times you find holes in those blue wraps. The tech cannot put the instruments on the fields until given the all clear from the circulator at my facility. Same with the instrument trays, we always check the filter before the instruments go on the field. It's just good practice.

hotdog19d · Mar 1, 2009

We do at both facilities I work at. It's a very good practice, and I'd say at least once every couple of weeks a wrapper will have a hole through both sides and is therefore not considered sterile.

$fracturenurse$ · Mar 1, 2009

We mainly do it in total joints. We hold it up to the light, and more than once I have found a little hole! It's good practice especially before you put it on the back table and contaminate everything!

maeyken · Mar 1, 2009

Always! :) I don't usually hold it up to the light but I do examine it. Usually scrub and circ both look at it.

Holding it up to the light does sound like a good idea though :)

KayceeCA · Mar 2, 2009

We never did at the other facilities where I worked, but we do where I work now. I agree that it's an excellent practice, because it's amazing how many times we find holes. It's especially important in total joint cases, and that's where it's really emphasized at my facility, but most of us have taken to checking during all procedures. We do hold the wrap up to the light also, because it's really easy to miss a hole in the textured blue wrap, but it stands out clearly when a pinpoint of light shines through.

brewerpaul · Mar 2, 2009

Yes, and especially in cases with implants.

scotsnurse72 · Mar 2, 2009

We check trays for holes before we open trays, when we are setting up for the following day, especially trays that we need which we only have 1 or 2 of, in case it needs to be resterilised for the next day. Especially the orthopaedic trays and our bookwalter retractor. Our trays come double wrapped, inside metal trolleys which are sent from the central sterilising unit in trucks so the trays can get moved about inside the trolleys during transport. The sterilising unit don't see our problems and aren't keen to change the delivery methods of our trays. I'd say at least 5-10% of our trays have a problem with the wrapping. I like the idea of holding the wrapper up to the light to look for small holes. I think I might suggest that one in the department :nurse: will keep many people happy.

MamaCheese · Mar 3, 2009

Always, always, always!! We hold ours up to the light and also check the filters on the metal tray covers and the peel packs. We used to have way too many holes in our wrappers. SPD has since changed to a heavier blue wrap, SPD plastic wraps heavier implant trays, we've lined our metal shelves with smooth plastic, and heavy paper wrapped trays are put in a tray liner before being transported from SPD. We've gone from holes in wrappers being an every day norm to just one or two a week. The changes have made a huge difference in our OR.

giddygiddygirl · Mar 9, 2009

I am shocked to hear that at some hospitals, the blue wraps aren't checked for holes EVERY TIME! Everyone where I work holds them up to look for a pinpoint of light and very often, there are holes, because of transporting them. I'm glad someone brought up the subject so that more people can make it standard practice! :yeah:

Scrubby · Mar 9, 2009

In my clinic we always check for holes in the sterile paper. It's scary how many times you find one.

I've scouted in other theatres and quite a few scrub nurses just take the tray and don't bother checking. The other day I found a hole and because the nurses just dumped the tray on the field without making sure it was sterile we had to get another whole set-up.

lindaloo51 · Mar 11, 2009

Always, always, always!! We hold ours up to the light and also check the filters on the metal tray covers and the peel packs. We used to have way too many holes in our wrappers. SPD has since changed to a heavier blue wrap, SPD plastic wraps heavier implant trays, we've lined our metal shelves with smooth plastic, and heavy paper wrapped trays are put in a tray liner before being transported from SPD. We've gone from holes in wrappers being an every day norm to just one or two a week. The changes have made a huge difference in our OR.

Question for you, who makes the tray liners?? I have been looking for them in my very limited spare time at work, but haven't found them.