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Packaging challenges in the operating room

RN Fran Koch of Presbyterian Hospital of Dallas examined 'Healthcare Practitioner and Patient Needs' at HealthPack 2006. "Flipping," Koch explains, is the art of opening a package in the OR. A person standing just outside the sterile field pulls the pack apart from two sides and flips the product out of the pack and onto the table on the sterile field. It isn't the best practice, Koch admitted, "but it works well and surgeons are renowned for it." Another packaging-related concern in the OR, she explained, is that "packaging waste can be a real issue. Two 55-gal trash bags may be filled with waste" during a surgical procedure. Koch addressed how packaging can make life difficult in the OR. Her comments at the March 14 conference session also included the following:

• Glove wrappers represent an age-old problem. We use a ton of them. There has to be a special way to open them so they don't fall out and become contaminated. Our motto is 'when in doubt, throw it out.' Would a different paper material [for the inner wrap] be so difficult? Also with surgical gloves, the packs are slippery and tend to fall off shelves.

• Tearing of peel pouches is a universal problem when you can't peel it open. A nurse develops a sense of how to get certain items delivered to the sterile field without contamination.

• Surgeons with big hands have trouble opening small packs. Also, a surgeon wants to look at [the package] to see if he needs a 6-mm or 8-mm patch. If the label print covers the product, the pack has to be opened. If it's the wrong [size], you have to throw it out and open another one.

• Instructions for use are critical. The OR staff tries to keep people educated, but with 250 employees, it's hard to keep everyone up to date. We need step-by-step instructions.

• A lot of vendors have no earthly idea what our [OR] equipment does.

• We have a lack of storage space, so we need compact packaging. Some products we receive are loaded with peanuts that fall all over the floor and increase disposal costs.

Regarding waste in the OR, Koch said that last year she identified $60,000 in packaging waste. There's "not that much red bag waste in the OR," she told the HealthPack audience.

Koch praised Ethicon, the Johnson & Johnson medical device company, saying "Labeling is extremely important to us. Ethicon suture [packs] have some of the most consistent labeling. We may have 30 or 40 bins of sutures, and it's easy for us to zero in on the color-coded products [because their packages] have the size of the suture clearly printed, showing the product." [HCP]

By Jim Butschli, Editor
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