Lecture 8 Supplies Rotation and Distribution

Effective control procedures should be established to ensure
every package is rotated ___________

First in First out (FIFO)

FIFO is also known as _____

Time related sterility

Give three examples of FIFO

Store items from the left and take from the right

Store at the rear take from the front

Store from bottom, take from the top

If there is any doubt of sterility, what must you do with the contents?

The contents must either be discarded or reprocessed.

Cases or boxes of medical devices must be inspected for damage - in those
boxes if damage is found individual items within the case or box must be
____

further inspected for damage

Can you place single-use medical devices for storage in shipping containers?

Why or why not.

No, they should be decanted from their boxes and placed in storage container in the sterile storage area

Sterility maintenance is dependent on but not limited to
the following criteria:

Type of wrapper used

Method of sealing the package

Type of shelving used that is either open or closed

Method and frequency of handling

Method, frequency and conditions of transportation

Environmental conditions of the storage area

Temperature

Relative humidity

Ventilation

Cleanliness and cleaning of sterile storage area and shelves

Amount of traffic and storage areas

Events that have occurred to sterile packaging- these would be outside factors such as the item became wet or it was dropped

Policies and standard operating procedures
must address the following issues:

Sterilization load indicators for traceability purposes

Sterilization date for stock rotation purposes

Adequate spacing of packages

Easy visibility and retrieval of packages

Visual inspection of all packaging before used

Storage conditions Handling practices for sterile items

In frequently used sterile packages should be stored
and closed or covered cabinets or dust
covers. Plastic dust covers can be applied following
the following practises:

Medical grade covers that are designated for this use

Clearly marked as a dust cover

Applied by personnel with clean dry hands or clean gloves

Sealed with a heat sealing device, tape design to seal plastic, or a self sealing closure

Applied to packages that are cool to room temperature so that no moisture will be trapped in the dust cover

Designed to not obscure package label

Periodic assessment of infrequently used steel
packages must be done in order to:

Determine whether they are still needed or required within the MDR department. Determine if they could be consolidated to reduce their numbers

Confirm that storage conditions are adequate to maintain product integrity and sterility

Written SOP‘s for the handling of sterile storage areas
must be in place to cover adverse events such as the
following:

Fire

Flooding

Water damage from pipes or sprinkler systems

Emergency requests for delivery and after hour deliveries

Sabotage or vandalism

Power outages

Pandemic influenza, viral hemorrhagic diseases

Distribution is mostly handled using the three
following systems: (3) NOTE: most departments will use more one of these systems depending on the type of item the user department needs and the urgency with which it will be required

Central dispatch

Top up/exchange cart

Case cart

How does central dispatch work?

Individual items are released from MDRD to user units when they are requested (either written or verbal)

What are they challenges of central dispatch?

Time-consuming

No department or person is directly responsible for managing the supplies

Nursing units over order and end up in surplus of supplies with nowhere to store them.

How does top up/exchange cart work?

Based on quota on actual use and is established for all supplies

The quota is the number that should be on hand in order to avoid under supply

The MDR tech will determine which items are below quota

The MDR tech is also required to generate a (pick sheet) that will have the list of all items and their quantities which are required

Once all items are on the cart, the cart will be sent to its destination

What are the two types of case carts

General and specific

What is a general case cart?

NOTE: carts must be cleaned after each use

A general case cart will contain a standard, predetermined selection of supplies required for common procedures

What is a specific case cart?

These carts have instruments that are to a surgeon’s preference.

The following is what a typical computer list would include

Type of surgery and basic instrument sets

Add-ons

Draping bundles

Gown bundles

Respiratory equipment

Sponges and gauzes

Suture material and scalpel blades

Post op dressing materials

If any items are not available when picking, what must you include with the cart?

Can the cart leave the MDRD until it has been completed?

A missing list

No

Medical devices must be transported in controlled environmental conditions: temperature of ___ to ___ and
humidity of __ to _ %

15 to 30°C

30 to 60%