AORN (Association of PeriOperative Registered Nurses) held its 56th Congress in Chicago in March 2009.  One of the topics of discussion was the correct way to use sterile count sheets with surgical instruments.  Chemicals used to make the paper and toner could potentially contaminate instruments during the sterilization process. Theoretically, this might pose a risk to sensitized patients.

One existing recommendation regarding this process was that “…sheets should not be placed inside wrapped sets or rigid containers”.  The current concern is that ink can be transferred whether the sheets are inside the containers or attached to the outside.  Procedures need to be in place to minimize the risk.  The online group responsible for this discussion may indicate necessary changes in future updates for AORN recommended standards and practices.

This is a special point of interest for AORN because they have for years been recommending the use of this method (using count sheets) for keeping track of instruments during surgery. There must be strict accountability for all equipment inside any operating room. The purpose of these count sheets is to keep surgeons and other OR staff from leaving items inside the patient.  This simple method for counting sterilized instruments can significantly reduce the risk of such a mistake. The ultimate goal is to prevent embarrassing and costly medical malpractice lawsuits.

A potential solution to the problem of chemical contamination is folding the paper so that the ink is on the inside and poses less of a risk of transfer. A second solution that has been tried is placing a sterile towel on top of the set before putting the sheet on top of it.  A third and perhaps better option has been to place the sheet inside its own sterilization bag.

Not having the sheets would present a far greater risk than that posed by the transfer of chemicals or ink.  Each department has handled the problem differently over the years.  Now it is possible that standardization of a proven method may be just around the corner.

About AORN History And Publications

AORN is the national association of OR nurses. It was formed from previous local and regional nursing organizations that existed between 1916 and 1949. They held their first national conference in 1954 and called it a Congress.  The group established the AORN Journal in 1963. Sterilization procedures and aseptic maintenance is one primary focus of this organization.

In 1965, The Standards for Administrative and Clinical Practice in the Operating Room was first published.  This publication’s name was subsequently changed to Perioperative Standards and Recommended Practices. The 2009 edition of these guidelines is now available online through the AORN website. It can be downloaded in Adobe format. Members, of course, receive a discount when purchasing this handbook.

Educating your staff about the proper methods to use during the sterilization process is important. These safety measures help ensure the controlled setting necessary for each patient to have the best chance at full recovery.  For optimal patient care, you also need the best equipment. If you are looking for sterilization or autoclave equipment that fits the budget of your organization and the needs of your patients, click on this free report for guidance.