Clean & Sterile Storage – Fast Facts

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Jun 3, 2014/ 0 Comments
Clean & Sterile Storage – Fast Facts

There are 2 main organizations that put out guidelines, standards or recommended practices:

1)  AORN (Association of periOperative Registered Nurses)

2)  AAMI (Association for the Advancement of Medical Instrumentation)

AAMI ANSI/AAMI ST79 – Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities

AAMI ST79 3.3.7.4 Sterile Storage

The sterile storage area should be located adjacent to the sterilization area, preferably in a separate, enclosed, limited-access area, the only function of which is to store sterile and clean supplies

  1. The storage system (e.g., open wire shelves, open solid shelves, or closed cabinets) should be selected on
    the basis of the environment in which it will be used, the packaging materials and systems used, the
    types of devices packaged, and the handling procedures employed at the health care facility.

Note:  Super Adjustable Stainless Steel for corrosion proof protection from the ‘environment’ or MetroMax i for corrosion proof protection and, as it applies to ‘packaging materials’, packaging protection from rips and tears.

  1. Closed or covered cabinets are preferable for high traffic areas. Open or wire shelving is suitable for
    confined storage areas, provided that proper attention is given to traffic control, area ventilation, and
    housekeeping.F

Note:  Starsys is an ideal solution for ‘covered cabinets’.

  1. Storage areas should be designed to protect sterile items and their packaging from damage. The

ventilation system should be designed so that air flows out of the sterile storage area (via positive

pressure). Other aspects of ventilation should comply with the guidelines set forth in AIA (2006) for OR environments. See also 8.9.2.

AAMI ST79 5.2.1 General considerations

  1. To protect individual items, bulk items may be stored in shipping cartons in the central receiving area. G
  2. Clean or sterile items to be transported to central processing and storage areas within the facility should
    be removed from their external shipping containers before they enter the storage areas of the
    department. Any instructions for use accompanying the items should be kept with the items. G

AAMI ST79 8.9.2 Storage Facilities

  1. Sterile items should be stored A
  2. at least 8 to 10 inches above the floor
  3. at least 18 inches below the ceiling or the level of the sprinkler heads (NFPA 13)
  4. at least 2 inches from outside [exterior] walls [to avoid condensation]
  5. The items should be positioned so that packaging is not crushed, bent, compressed, or punctured and so
    that their sterility is not otherwise compromised. C
  6. Medical and surgical items, including those packaged in rigid sterilization containers, should not be

stored next to or under sinks, under exposed water or sewer pipes, or in any location where they could become wet. D

  1. Heavy instrument trays should be stored on middle shelves (but not stacked) for ease of handling by

staff; transport trays with solid or perforated bottoms may be used to prevent tears in wrappers during handling. (See also 3.3.7.4.)




  1. Supplies should not be stored on floors, on windowsills, or in areas other than designated shelving,
    counters, or carts. D
  2. Closed or covered cabinets are recommended for the storage of seldom-used supplies. Open shelving
    may be used, but requires special attention to traffic control, area ventilation, and housekeeping. F

Note:  Starsys is the recommended storage solution over an open shelving solution.

  1. For sterile and clean supplies stored on the bottom shelf of an open-shelf (wire) cart, there should be a
    physical barrier between the shelf and traffic or housekeeping activities. A

Note:  This is the standard that drives the need for a solid bottom shelf.

  1. Outside shipping containers and corrugated cartons should not be used as containers in sterile storage
    areas. G (See also 5.2.1.)

Note:  The customer should be purchasing bins, totes and/or ledges and dividers for this function.

  1. Shelving or racks used for the storage of rigid sterilization container systems should be designed for the
    weight and configuration of the containers.

Note:  The maximum loaded weight of a container recommended by AORN is 25 lbs.

  1. When stacking [rigid] container systems, the user should take care to ensure that they are firmly seated
    one upon another and that they can be removed easily.

Note:  Does this mean sterile packs [blue wrapped packs] can be stacked?  NO.    This statement

directly follows the statement on rigid containers so the inference to stacking would only be to the rigid container. Refer to manufacturer [of blue wrap] instructions on proper handling.

  1. Written policies and procedures for the storage, handling, rotation, and labeling of container systems
    should be developed and enforced.

Note:  Remember, the Joint Commission is also enforcing is the hospital’s own policies.  These need to
be considered in addition to the written standards and practice provided by industry organizations.

Rationale for the “storage” standards:

  1. Adequate space is needed around sterile materials to
  2. allow for air circulation in the room [spacing]
  3. prevent contamination during cleaning of floor [solid bottom shelf]
  4. prevent contact between sterile items and the condensation that might form on the interior surfaces

of outside walls. [2” to exterior wall].

  1. Also, fire codes specify minimum distances below the ceiling to ensure the effectiveness of sprinkler systems
    (see NFPA 13).  [18” clearance]
  2. Compression of packages can force air and microorganisms into the package contents, cause seals to burst, or
    puncture the packaging, all of which lead to contamination.

Note:  AORN recommends following manufacturer written instructions.  Most blue wrap manufacturer instruction state that wrapped packs should not be stacked.

  1. Sterile items that become wet are considered contaminated because moisture brings with it microorganisms
    from the air and surfaces.
  2. Sterile items should not be stored anywhere but on or in designated shelving, counters, or containers, because
    other areas might not be sufficiently clean, and because windowsills collect condensate that forms because of
    differences in temperature between inside and outside air.
  3. Closed cabinets limit dust accumulation, discourage handling, and minimize inadvertent contact with sterile
    items.
  4. Shipping containers have been exposed to unknown and potentially high microbial contamination, and

corrugated containers serve as generators of and reservoirs for dust; hence, shipping containers should never be allowed in the sterile storage area.

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