Office Procedure Tray Processing
Looking for some advice for sterile processing of our instrument trays: we have a high volume Mohs clinic, about 18-20 procedures per day. Our current process is the following:
- Wash any debris from instruments, place in sonicator with enzyme cleaner for 15 minutes.
- Rinse with sterile water and pat dry. (We use instrument lubricant once per week due to the long time to dry.)
- Place an OR towel on a sheet of CSR wrap (we currently use Halyard H500). Place a stack of 4x4s, 2x2s, dental rolls, and cotton tipped applicators in an even layer with a steam integrator strip.
- Place open hinged instruments over stack, followed by small stack of 4x4s, then the straight instruments. Stack bowls with gauze in between them and invert over the instruments.
- Wrap OR towel semi tightly around the stack. Wrap CSR wrap tightly like a burrito around towel. Tape CSR wrap with indicator tape.
- Run on "packs" cycle on autoclave (Midmark M11 steam autoclave).
I would love any advice or tips to help reduce waste, simplify the process, or be able to fit more kits with each cycle in the autoclave. I've attached a photo of our trays for reference. I run mail in spore strips in one of the kits each week and haven't had a positive test in 6 years. Surgical site infection rate is also far below the national average for our specialty - although just one factor in that measure, I believe everything we are doing for sterile processing is appropriate. The hard part is that as a private derm practice we don't have access to some of the resources that larger institutions have - but I do have access to McKesson to order within reason 😄! Thank you in advance for any insights!