Rethinking Sterilization Practices: Evidence for Event-Related Outdating

Abstract

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. Cambridge University Press and ABSTRACTWe administered a web-based questionnaire to SHEA, APIC, and EIN members to assess the frequency of fires associated with alcohol-based hand rub (ABHR) dispensers in healthcare settings. None of the 798 responding facilities using ABHRs reported a dispenser-related fire; 766 facilities had accrued an estimated 1,430 hospital-years of ABHR use (Infect Control Hosp Epidemiol 2003;24:618-619).Alcohol-based hand rubs have been used routinely by healthcare workers (HCWs) in some parts of Europe for decades.1-3 Compared with soap and water hand washing, these products require less time to use, can be more accessible than sinks, cause less skin irritation and dryness, are more effective in reducing the bacterial count on hands, and when made widely available within an institution, have been shown to improve hand hygiene practices among HCWs. 4 In view of these advantages, the Healthcare Infection Control Practices Advisor y Committee of the Centers for Disease Control and Prevention recently recommended the routine use of alcohol-based hand rubs by HCWs, as long as their hands are not visibly soiled with blood or other proteinaceous material.5 To make these products readily accessible to HCWs, the new Guideline for Hand Hygiene in Healthcare Settings 5 recommends that alcohol-based hand rub dispensers be placed adjacent to patient beds, in hallways immediately outside patient rooms, and in other convenient locations. However, the implementation of alcoholbased hand rubs, particularly the placement of the dispensers in hallways, has been impeded in healthcare facilities in several states because of the concerns of local fire marshals that they may pose a fire hazard. METHODSTo obtain data on the frequency of fires related to alcohol-based hand rub dispensers, we administered a web-based questionnaire to members of the Society for Healthcare Epidemiology of America (SHEA), the Association of Professionals in Infection Control and Epidemiology (APIC), and the Emerging Infections Network (EIN) of the Infectious Diseases Society of America in March 2003. We obtained information regarding the routine use of alcohol-based hand rubs in facilities, the date (month and year) that the use began, the location of the dispensers within the facilities, and whether any fires had been attributed to the dispensers. We also asked whether they had been instructed by local fire marshals to remove or relocate the dispensers from hallways, change the size of the dispensers, or change the storage conditions of large stocks of alcohol-based hand rubs. Finally, we calculated the months of use of alcohol-based hand rubs for each facility and the cumulative months of use ...

Time-dependent recontamination rates of sterilised dental instruments

“…Such a burden is not without associated costs in materials and manpower as already shown. 18 At present the guidance on storage times following sterilisation in primary care does not appear to be evidence-based and the recommendations are not supported by this study.…”

“…At a conservative estimate of just AUS $5 per item to cover the manpower and equipments costs, the annual bill to reprocess these unused instruments was estimated to be in the order of AUS $90,000. 18 At present there appears to be a lack of evidence in the dental literature on the length of time sterile instruments may remain bagged before use, which brings into question the validity of the current UK guidance to primary care dentists. If a sterilised item can be considered to be sterile almost indefinitely then provided the packaging remains dry and intact, HTM 01-05, 5 with its 60 day recommendation, appears to be placing an extra and possibly unnecessary burden on UK primary care dentists.…”

Temperatura e umidade no armazenamento de materiais autoclavados: revisão integrativa

“…An experiment (17) was conducted to compare the shelf life of sterilized materials with the "event-related" control. This paradigm assumes that the sterilized and suitably packaged material remains in this condition until the package is damaged, which may occur due to humidity, tears, dents or breakage of the seal (18) .…”

Specifications for temperature and humidity in sterile storage environments – Where's the evidence?

“…Other studies indicated temperature and/or humidity were not controlled or monitored during storage periods and results of sterility testing did not indicate higher levels of contamination. 17,18 Webster et al 19 attempted to examine the effect of a variety of controlled and uncontrolled storage conditions in their study over a 2-year period. One interesting finding was from testing articles Specifications for temperature and humidity in sterile storage environments Healthcare Infection Specifications for temperature and humidity in sterile storage environments Healthcare Infection stored in a box in the rear of a car for 9 years.…”